Aidas Haven Solutions
Adoption application
Animal you are interested in adopting
*
General Application Inquiry
Theo - Rottweiler Neutered Male ($250) Black/Rust
Wilma - Mixed breed Spay Female ($300) Grey/White
If you are just filling out for a general application to the rescue what breed are you looking for?
General Applicant Information
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
-
Area Code
Phone Number
Best time to call?
*
Morning
Afternoon
Evening
Email
*
example@example.com
Years lived at current address?
*
Rent or own?
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Rent
Own
If you are a renter, please provide landlord contact information.
*
If owned, is there any HOA restrictions on breed/size?
*
Yes
No
Unsure
Are you willing to submit a photocopy of your driver's license? If yes email a copy to aidashavendogrescue@gmail.com
*
Yes
No
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Veterinarian information
If you don't have a current veterinarian or are a first-time animal owner, please ask for a list of recommended veterinarians.
Current veterinarian:
*
Current veterinarians address:
*
Current veterinarians phone number:
*
Years at current veterinarian:
Do you agree to your veterinarian releasing any medical information (such as verifying vaccination status) as we may have questions about with your current animals in the household? (You will still have to give permission by calling your veterinarian stating that a representative of Aidas Haven will be reaching out)
*
Yes
No
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Household Information
Number of people in household:
*
Number of adults:
*
Any children?
*
Yes
No
If yes, how many:
Ages of children in household:
Source of income?
*
Full-time or part-time?
*
Who takes care of the animals in the household?
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How many hours are the animals left alone?
*
Where does the animal stay while you're gone or working?
*
How many hours a week can you devote to the animals basic obedience and training needs?
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If you cannot train yourself, are you able to find training or resources?
*
Do you have a fenced yard?(A fenced yard is not a requirement however we will then be able to place a better dog with you based on that particular dog's needs)
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Yes
No
If no, do you have an adequate space to walk to exercise your dog?
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Other pets in the household?
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Yes
No
If yes, how many?
Are all animals in the house hold up to date on their rabies vaccinations?
*
Yes
No
No pets that require vaccination
(If no, all animals MUST be up to date on Rabies vaccinations two weeks prior to Application approval, failure to furnish proof of rabies certificate will result in your Application being denied)
Animals in Home (List Name, Age, Sex, Breed)
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Personal References
Please list three references below:
Reference 1 (Name, Address, Phone, Years Known
*
Reference 2 (Name, Address, Phone, Years Known
*
Reference 3 (Name, Address, Phone, Years Known
*
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Additional Information
Breed Experience
Please lightly explain the experience in the breed you are interested in? (This better helps us ensure that the animal you are interested in, is the best fit for you.)
Are you able to handle any Behavior issues that are common in the breed? (All animals have been cleared for adoption, any information disclosed is to the best of our knowledge of the animals temperament, and cannot predict how the animals temperament may change in the long run as the animal ages.)
Are you aware and or prepared to deal with any known health issues of the animal you are interested in adopting or the potential issues of the animals breed? (All animals have been cleared healthy at the time of the adoption, we do not know the animals genetic makeup or issues to the animals health in the long run)
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