Journey Homeward Animal Rescue
Adoption Application
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Format: (000) 000-0000.
Email
example@example.com
Are you interested in a specific animal? If so, what is their name?
If the animal you are interested in is unavailable, are you open to other suggestions?
Adults in the home and their ages.
Children in the home and their ages.
List all pets you currently own. Please list: gender, age, breed, vaccination status and if they're spayed or neutered.
Who will be the primary care giver?
What is the name of your current vet?
What is your experience with animals?
Employment status?
Full time
Part time
Work from home
Stay at home parent
Student
Retired
Unemployed
Other
Is everyone in the home in favor of adopting a dog/cat?
Is anyone allergic to cats or dogs?
What time of residence do you have
Aparment
Condo
Townhouse
House
Mobile home
Other
Do you rent or own?
If you rent, do you have the landlord's permission to have a pet? Are there any restrictions?
Do you have plans to move in the near future? (1-2 years)
May we visit your home prior to adoption?
If you do not have a specific animal in mind, what are you looking for in a pet?
Gender
Age range
Breed
Are you willing to adopt a dog that needs house training ?
Are you willing to adopt a dog that needs obedience training?
Are you willing to seek out professional training if necessary?
Would you consider a special needs animal? Elderly animal?
Why do you want to adopt a rescue animal?
How big is your yard? (approx)
Is your yard fully fenced?
How tall is the fence? What type?
Will the dog have water access?( Pool, Lake, River or Pond )
Will the cat/dog be an indoor pet or an outdoor pet? How many hours a day will the dog be left outside unattended?
How many hours a day will the dog/cat be left home alone? Do you have someone who can check in on them?
What is your exercise plan for your dog?
Do you have a dog/cat door
Yes
No
Other
What is your preferred brand of food for your animals?
Feeding schedule?
Once a day
Twice a day
Food left out/free feed
Other
Where will the cat/dog sleep?
Do you plan to use a crate for your dog?
Where will the dog be kept when you are not home?
Do you plan to use an outdoor kennel or tie out for your dog?
Do you have a plan for you dog/cat when you go to work or on vacations?
Have you ever relinquished a pet before? Please explain if yes.
Are there any reasons that would cause you to return the dog/cat? (baby, moving, behavior issues, ect) JHAR requires all our adopted dogs be returned to us if unable to remain in your home.
Have you owned a dog/cat before? If so, how did you loose your last pet?
Date
-
Month
-
Day
Year
Date
Please provide any additional information about your family or lifestyle you think is important for us to know.
List 3 references. Include full name, relation to you, length of time aquainted and phone number.
Submit
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