“All his life he tried to be a good
person. Many times, however, he
failed. For after all, he was only
human. He wasn't a dog.”
- Charles M. Schulz


Fill out the form below or download the form here.

Contact Information

You and Your Household

The Dog for Me

History of Pets in the Household

Please list all pets owned in the past 5 years

Type of Pet?

How long owned?

Reason no longer owned?

I certify that I am at least 21 years of age and the information I have given is true. I recognize that any misrepresentation of facts may result in losing the privilege of adopting a companion animal and I understand that Kanawha-Charleston Humane Association has the right to deny my application for adoption.