"You cannot look at a sleeping cat and feel tense." ~Jane Pauley
"No man can be condemned for owning a dog. As long as he has a dog, he has a friend; and the poorer he gets, the better friend he has." ~Will Rogers
Louisa Humane Society P.O. Box 1837 Louisa, VA 23093 email: info@louisahumanesociety.com
To submit an application to adopt an animal, please complete the form below. Bold fields are required.
Thank you for your interest in adopting one of our animals!
Name (First & Last) A value is required.
Address A value is required.
City A value is required. State A value is required. Zip A value is required.
Home Phone Invalid format.
Work Phone Invalid format.
Email A value is required.Invalid format.
Drivers License/ID# A value is required.
How long have you lived at your current address? A value is required. Do you own or rent your home? I own my home. I rent my home.
If you rent, what is your landlord's name and phone number?
Do you live with relatives? Yes, I live with relatives No, I do not live with relatives
Do you have plans to move soon? Yes, I plan to move soon No, I do not plan to move soon.
Do you work outside your home? Yes, I work outside my home. No, I work in my home.
If yes, how many hours are you away from home? A value is required.
How many children are living in your household? A value is required.
How many adults live in your household?
What is the annual amount you might plan to spend on this animal? Select a range $50-$150 $150-$300 $300-$500 $500-$1000 more than $1000
Who are you adopting this pet for? for myself for a relative for a friend for my spouse for another pet I have other
What LHS animal are you interested in adopting - or what breed/size are you looking for? Please specify name(s) of LHS animals, whether you would like a cat/dog, or if you are looking for a specific breed or size of animal...
Please list animals you currently own - Include type of animal, sex, spayed/neutered, age, kept indoors/outdoors, current on annual vaccinations:
What is the name of your current veterinarian? A value is required.Invalid format.
What is your current veterinarian's phone #? Invalid format.
Please list the types and breeds of pets you have owned in the last ten years - Include type of animal, age, how long, and what happened to him/her?
How will you confine your pet to your property? Select one Fence Dog run Trolley Stake in the ground Invisible fence Other
This pet will be Indoors only Outdoors only Indoor/Outdoor Not sure yet
Where will this pet be kept during the day?
Where will this pet be kept at night?
