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Application to adopt a dog |
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| Your Information: |
| Name |
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Spouse / other |
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| Address |
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City, State, Zip |
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| Home Phone |
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Work Phone |
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Occupation |
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| Email Address |
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Hrs work / week |
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| Are you over 21? |
Yes
No |
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| Have you adopted from HFA previously? |
Yes
No |
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| References: please vary your reference types |
| Type of reference |
Professional
Friend
Other:
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| Name |
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Relationship |
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| Address |
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Phone |
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| Email Address |
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| Type of reference |
Professional
Friend
Other:
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| Name |
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Relationship |
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| Address |
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Phone |
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| Email Address |
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| Type of reference |
Professional
Friend
Other:
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| Name |
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Relationship |
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| Address |
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Phone |
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| Email Address |
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| Your Veterinarian: |
| Name |
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Address |
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Phone |
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| Your Boarding Kennel: |
| Name |
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Address |
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Phone |
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| Your Groomer: |
| Name |
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Address |
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Phone |
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| Please describe the kind of dog you are interested in adopting: |
| Is there a special dog on the web site that you're interested in? Their name: |
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| Age |
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Sex |
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Breed / mix |
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| Size |
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Coloring |
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Temperament |
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| Reason for sex preference: |
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| Why do you want a dog? |
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| Can you commit to care for the dog for it's entire life? |
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| Why do you like the breed/mix you're interested in? |
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| Have you owned the breed/mix before? |
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| Your Dogs: |
| How many dogs do you have? |
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Breed / Mix |
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| Ages: |
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| What happened to them? |
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| How many dogs have you had? |
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| Any bought from a breeder? |
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Any brought from a pet store? |
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| Adopted from a shelter? |
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Inherited? |
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| Found stray? |
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Other? |
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| Do any of your dogs have any physical problems? |
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| Do any of your dogs have behavior problems? |
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| Do they get along with other dogs? |
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| If so, what type of breed? |
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| Mix of dogs? |
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| Size of dogs? |
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| Your Children: |
| How many children in the home? |
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Ages? |
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| Have they had dogs before? |
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Was it successful? |
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| How often? |
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| Your Cats: |
| How many cats do you have? |
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Ages? |
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| Do they get along with dogs? |
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Behavior? |
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| Are they declawed? |
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Inside/Outside |
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| Other pets? |
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| Your Home: |
| Number of adults in the home? |
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Own or rent? |
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| Does any member of your family have allergies to animals? |
Yes
No |
| If you rent, do you have permission from your landlord to have a dog? |
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| Landlord's Name |
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Phone Number |
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| Your home is a:
Apartment (What Floor
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Townhouse
Single home
Mobile home
Otherr |
| Yard size? |
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Fenced? |
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Height? |
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| Any community restrictions on dogs? |
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| Spay / Neuter: If the dog you want to adopt is not yet sterilized, you agree it will be sterilized by 6 months of age. Proof will be required. |
I Agree |
| Home Visit: You agree to allow us to visit your home by appointment as part of our application process. |
I Agree |
| Application: All of the information I/we provided in this application is true and correct. I/we will contact you if any of the above information changes. |
I Agree |
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you need to agree to all 3 before submitting your application |
