Hopes Haven Adoption Application

Hopes Haven Online Adoption Application
Applicant

First NameLast Name
Co-applicant

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Daytime Phone

Area CodePhone Number
Evening Phone

Area CodePhone Number
E-mail
Employment
Occupation
Employer
Work Phone
Years at current job
Housing
How long have you lived at your current address?
If less than three years, where did you previously live?
Do you rent or own?

OwnRent
Landlord's Name
Landlord's Phone
Pet Restrictions, if any
Household
Please list the ages of all members of your family
If there are other children that regularly visit your home, please list their ages
Is anyone in your household allergic to dogs?

YesNo
Would you consent to a pre-adoption visit?

YesNo
Please describe your currents pets, male/female, age, and whether they are spayed or neutered.
What other pets have you owned in the past five years?
Veterinarian
Who is your current vet?
Vet's Location
Phone Number

Area CodePhone Number
Adopting a Hopes Haven Dog
What dog would you like to adopt?
Is your yard fenced (dog secure)?

YesNo
If not secure, what are you doing to remedy that?
If living in an apartment, how will you "potty" your dog?
How will your dog get play/exercise?
How many hours a day will your dog be left alone?
Where will your dog be kept when you are not home?
Have you ever used a crate to train a dog?

YesNo
Have you ever trained a dog in basic obedience?

YesNo
If needed for better control, would you be willing to take your dog through a basic obedience class?

YesNo
Why do you want to adopt this dog?
Who will be primarily responsible for this dog?
Are you willing to commit yourself and your energies to this dog for its lifetime?

YesNo
Are you financially prepared to provide the necessary care for your dog, including proper food, vaccinations, parasite control, licensing, adequate shelter, and veterinary care for yearly check-ups or an after-hours medical emergency or illness, which could cost $500 or more?

YesNo
What do you consider a good reason to give up a dog?
What concerns, if any, do you have about adopting this dog?
Are there any special circumstances you would like us to be aware of?
By clicking on the "Submit" button, I certify that the above is true and acknowledge that false information may nullify the adoption.
I understand this is only an application and does not entitle me to adopt a dog from Hopes Haven.
Should be Empty:

Hopes Haven Online Adoption Application

Employment

Housing

Household

Veterinarian

Adopting a Hopes Haven Dog

By clicking on the "Submit" button, I certify that the above is true and acknowledge that false information may nullify the adoption.

I understand this is only an application and does not entitle me to adopt a dog from Hopes Haven.