PROSPECTIVE ADOPTER INFORMATION Coshocton County Animal Shelter & HATA Thank you for your time and interest. We verify the information provided prior to setting up an appointment or meet and greet. Adopter name Adopter address Adopter age County of residence Email Phone for contact Current Veterinarian Reference Name your vet records are under Do you rent or own your home? ownrent If rent, landlord information Veterinarian Record of spay and neuter surgery of current pets: (please list your CURRENT resident animal(s) name, animal type, veterinarian who spayed/neutered and the phone number for that vet) Have you ever surrendered a pet to a shelter? noyes If yes, under what circumstances? Stray turn ins do not need listed. Members of Household, everyone who lives in the home, full or part (time, ages and names) Hope to adopt: Type of animal, name of animal, or animal you are searching for: (Please be DETAILED! Hair length, color, likes/dislikes, age open to...)