Adoption Application

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PLEASE ONLY APPLY IF YOU AND EVERYONE IN YOUR HOUSEHOLD IS 100% READY TO ADOPT AT THIS TIME. DO NOT APPLY IF YOUR SIGNIFICANT OTHER, HOMEOWNERS, ROOMMATES OR ANYONE THAT WILL EFFECT THE DECISION OF KEEPING AND TAKING CARE OF YOUR PET, IS ON BOARD. IF EVERYONE IS READY, PLEASE CONTINUE ON AND APPLY. IF NOT, PLEASE EXIT AND APPLY WHEN YOU ARE OFFICIALLY READY
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Name
First Name
Last Name
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Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
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Email address* This field is required.
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Phone Number
Area Code
Phone Number
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Verification* This field is required.
I verify that I am 21 years of age or older, have identification showing my current address, and have knowledge and consent of my landlord. I understand falsification of information will lead to rejection of this application. I understand filling out an application does not reserve or hold an animal for me prior to adoption and that HES reserves the right to refuse adoption to anyone.
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Salary and Occupation we ask this, because we want our animals to have the best care they can once leaving us.
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Are you interested in a specific pet that you have met at the shelter or seen on our website? Please let us know who your top choices are.
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What kind of pet are you interested in? Check all that apply.* This field is required.
Kitten
Adult Cat
Senior Cat
Puppy
Adult Dog
Senior Dog
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What size pet are you looking for?* This field is required.
Small
Medium
Large
Huge
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Why are you interested in adopting a pet? (check all that apply)* This field is required.
Companion
Child's pet
Gift
Guard dog
Company for Other Pet
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What qualities are you looking for in a pet? (check all that apply)* This field is required.
Friendly
Playful
Affectionate
Energetic
Aggressive
Quiet
Gentle
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What energy level are you looking for?* This field is required.
High Energy (Daily vigorous exercise)
Medium Energy (A daily walk)
Low Energy (Couch buddy)
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How do you feel about the following behaviors?* This field is required.
OK or Manageable
Cannot tolerate
Jumps on people
Chews
Mouthy
Doesn't like other animals
Doesn't like kids
Destructive inside
Separation anxiety
Jumps on people
Chews
Mouthy
Doesn't like other animals
Doesn't like kids
Destructive inside
Separation anxiety
OK or Manageable
Cannot tolerate
OK or Manageable
Cannot tolerate
OK or Manageable
Cannot tolerate
OK or Manageable
Cannot tolerate
OK or Manageable
Cannot tolerate
OK or Manageable
Cannot tolerate
OK or Manageable
Cannot tolerate
1 of 7
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If a behavior cannot be tolerated or changed after adoption, what steps would you take?
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Do you currently have pets in the home? * This field is required.
No
Yes
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If you do have pets in the home, please describe them below.
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If you do have other pets, what kind of identification do they have?(Microchip/tag)
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How many people are in your household?* This field is required.
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What are the ages of the people in your household?* This field is required.
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Are you above the age of 60 & want a younger pet under 10 years? YOU MUST HAVE A CO-signer.Things happen unexpectedly and its important that we have plan in place for this animal. If you are above 60, in order to adopt you must be willing to find someone to co-sign the adoption agreement with you. Are you willing? ( sometimes we will make exceptions for senior animals). Are you willing to do this? (please note your application will be rejected if you choose NOT TO DO this option)
Please Select
Please Select
Yes I am 60 and AM WILLING have a back up plan and someone to sign the contract
Yes, I am 60 years old and am NOT WILLING to have this contract signed
No, I dont need to because I am under the age of 60
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Where do you live? * This field is required.
House
Apartment
Condo/townhouse
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Do you own or rent?* This field is required.
Own my own home
Rent
Live with parents or homeowner
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If you rent, is a pet deposit required?
Yes
No
Don't know
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If you rent, provide the name and phone number of your landlord. If you are the homeowner, please provide proof. If you own, (put will provide proof).
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How many hours will your pet be left alone each day?* This field is required.
1-2 hours
3-4 hours
4-6 hours
8-10 hours
10+ hours
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What are your plans for your pet when you are NOT at home? Please describe in detail. * This field is required.
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What are your plans for your pet when you are AT HOME and AT NIGHT? Please describe in detail.* This field is required.
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Do you have a fully fenced yard?* This field is required.
Yes
No
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How would you describe your lifestyle? What does a typical day look like for you?* This field is required.
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Tell us about your past experience with pets. * This field is required.
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How long did you have previous pets and why are they no longer with you?* This field is required.
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Do you have a regular veterinarian with vet history?* This field is required.
Yes
No
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If you dont currently have a vet, where are you planning on taking your pet for medical needs? Please list the name and address
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If so, which veterinarian (Name, Number, Address)? * Are you willing to call your vet and disclose any information to ASAP ANIMAL RESCUE ?
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Are all pets you currently have up to date on annual vaccines?
Yes
No
Dont currently have pets
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Please tell us anything else you would like to share about you, your family, your lifestyle, your ideal pet, your past pets, or anything else.
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Can you provide 2 references and give ASAP animal Rescue Permission to contact them?WE ASK NOT TO BE FAMILY and must be over the age of 21.
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NameReference #1
First Name
Last Name
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Phone NumberWe Prefer cell phone numbers
Area Code
Phone Number
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Is the phone number you entered landline/ house phone?*We ask this for contact purposes*
YESNO
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Email
example@example.com
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Namereference #2
First Name
Last Name
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Phone Number
Area Code
Phone Number
45
Email
example@example.com
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Are you aware of adoptions fees and why ? Dogs $300-$850. Cats ($300-$450) (DEPENDS ON AGE & BREED)
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As of right now ASAP Animal Rescue is Foster based. Once you pass the interview process, you will need to make an appointment with the foster of the animal you are wanting to adopt at the address of the foster. Expect to spend at least 30 minutes in person. Are you comfortable and are able to accomodate to that?
Huge
Large
Normal
Small
Ok
Ok
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