Form Center

2. 
3. Butte-Silver Bow Animal Shelter
   699 Centennial Ave Butte, MT 59701 406-497-6528 BSBAnimalShelter@bsb.mt.gov
7. To help us determine potential matches for you, please complete the following:
9. Name of Animal:
10. Date
12. Species

    1. Dog

    1. Cat

    1. Other
14. I am currently:

    1. Employed - Full Time

    1. Employed - Part Time

    1. In School

    1. Stay at Home
16. I am looking for a pet whose energy level is:

    1. Low

    1. Medium

    1. High
18. There are_____humans in our household.
19. Their ages range from___to___:
21. I intend for my pet to spend most of its time:

    1. Indoors Only

    1. Indoors/Outdoors

    1. Outdoors Only

    Some pets require more secure containment than others. Please consult with your adoption counselor about humane containment recommendations for your pet's unique needs.
23. Behaviors I prefer not to manage are:
25. Please list all other pets in your home:
27. Is This your first time adopting a shelter animal?

    1. Yes

    1. No
28. Have you had pets before?

    1. Yes

    1. No
32. Applicant Information
34. First Name
35. Last Name
37. Address1
39. Address2
41. City
42. State
43. Zip
45. Contact Phone Number*
46. Email Address
48. Have you ever surrendered/returned a pet to BSB Animal Shelter?

    1. Yes

    1. No
50. Do you own your residence?

    1. Yes

    1. No

    If you rent, please provide your landlord's or property manager's contact information below:
52. Landlord's/Property Manager's Name:
53. Phone:
55. Do you have a veterinarian?

    1. Yes

    1. No

    If Yes, please provide your Vet's contact information below:
57. Veterinarian's Name:
58. Phone:
60. I would like to be contacted and notified about potential adoption matches in the future:

    1. Yes

    1. No
62. This application does not reserve an animal for applicants during the approval process. Adoption applications are approved or denied at the discretion of BSB Animal Shelter. By signing below, I certify that I am 18 years of age, and that all the information I have provided herein is true and correct to the best of my knowledge. I understand that providing false or incomplete information may be grounds for my adoption to be denied. I understand that this adoption application is not a binding contract with BSB Animal Shelter and that at any time I may be denied adoption at the discretion of BSB Animal shelter.

    1. Agree
    2. Disagree
Leave This Blank:


64. 1. Receive an email copy of this form.
65. Email address

    This field is not part of the form submission.

66. Submit

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