Rescue Dog Adoption Application

Helping Paws22 Dog Adoption Application

HP22Adoptions@gmail.com
Helping Paws22 Rescue is an all-volunteer, non-profit, animal welfare organization dedicated to the rescue and placement of stray, neglected and abused animals. Helping Paws22 Rescue is completely funded through fundraising efforts and public donations. All of our pets are cared for by foster homes and receive complete medical care, which includes worming, vaccinations and spaying/neutering prior to their adoption.
This application is designed to help Helping Paws22 Rescue and yourself determine if a specific dog is the right one for you and your household. All adopting parties are required to complete each question on this application. Incomplete applications will not be considered. Please answer each question in as much detail as possible or answer N/A if it doesn't apply.
Applicant Information
Name(s) of the dog(s) you wish to adopt:*
Your full name:*
Your age:*
Street Address:*
City, State, Zip*
Email*
example@example.com
Home Phone:

Area CodePhone Number
Cell Phone:

Area CodePhone Number
Household Information
Are all members of your household in agreement with this adoption?*

YesNoDon't Know
Who will be the pet's primary caregiver?*
Do you live in a*

HouseApartmentCondoMobile HomeDuplexOther
Do you own or rent?*

OwnRent
If rent, provide name and phone number of landlord:
Does your landlord allow dogs?

YesNoDoes not apply (I own)
Are there any restrictions from your landlord or subdivision?*

Number of petsSize or weight restrictionsBreed restrictionsNone
Do you have a fully fenced yard?*

YesNo
Height and type of fence
Would you walk/excercise a dog on or off-leash or both?*

Off Leash (fenced area)On Leash (walks, etc)Both
How many adults are in your household?*
How many children are in your household?*
If children, what are their ages?
Have your children been around animals before?

YesNoN/A No kids
Does anyone in your home have allergies to dogs or have asthma?*

YesNo
Current/Previous Pet Information
List any pets you own or have owned in the past five years, and their ages
How many of these pets are spayed/neutered?
Where are these animals now?
Have you adopted from an animal welfare group before?

YesNo
If yes, what group?
Have you ever given up a pet?*

YesNo
If you have given up a pet, what were the circumstances?
Please provide the name and phone number of your current and/or previous veterinarian or clinic (if first time owner please list the vet you will be taking your dog to):*
New Pet Information
What type of personality do you want your pet to have? (i.e. calm, energetic, protective, couch-potato)*
Would you be willing to obtain a crate if recommended for the dog?*

YesNo
Do you understand and accept that changing a dog's environment may cause the dog to have accidents, especially in the early days of the adoption?*

YesNo
If the dog has an "accident" in your home, what type of correction do you plan to use?*
How many hours each day will your new pet be home alone?*
Where will your new pet sleep at night?*
Where will your new dog stay when nobody is home?*
Are you willing to keep a collar with a tag bearing your name and phone number on your dog at all time?*

YesNoSometimes
Are you aware that a new environment is stressful for your pet, and they may exhibit uncharacteristic behavior?*

YesNo
If a behavioral problem arises, what steps will you take to work on it?*
The average dog has a lifespan of 12 to 15 years. Are you willing to make a commitment to this dog for the rest of his/her life?*

YesNo
Are you aware and do you accept that Helping Paws22 requires that all dogs and cats in the household be spayed/neutered before an adoption of a Helping Paws22 dog can take place?*

YesNo
What circumstances would lead you to give up your new dog?*
If, for any reason, you are unable to keep your dog, do you agree to notify Helping Paws22 immediately?*

YesNo
If you are unable to keep your dog, do you agree to return him/her to Helping Paws22 Rescue without hesitation and at your own expense?*

YesNo
Please provide the names and number of two people we may contact to serve as references for you. (vet, family, friends, etc.)*
Please list any concerns or final questions here:
How did you find out about Helping Paws22 Rescue?*

Petfinder.comFacebookFriend/Family MemberOther websiteAdoption EventOther
I have read the above information carefully and have filled out this application honestly.

I understand that omission of information and/or failure to answer all questions and sign the application can result in being declined. Also, if an omission or untruth is discovered after an adoption takes place, I understand and accept that Helping Paws22 has the right to annul the adoption and reclaim the dog.

I give Helping Paws22 permission to fully investigate the information provided as well as contact veterinarians and references. If the application passes this review, I agree to a possible home and yard visit on a mutually agreed date by a Helping Paws22 representative before an adoption decision is made.

Furthermore, I understand and accept that the adoption decision depends upon many factors, including - but not limited to - the compatibility of the family and home to the individual dog and other applications received on the dog. I understand and accept that Helping Paws22 will decide which home is most appropriate for the individual dog, and therefore I will not take issue with the decision.
Signature

Clear
Printed Full Name:
Date:
Please click submit or e-mail completed applications to HP22Adoptions@gmail.com.
Should be Empty:

Helping Paws22 Dog Adoption Application

Applicant Information

Household Information

Current/Previous Pet Information

New Pet Information