Hay River Animal Shelter Adoption Application

Please select if you are applying to;*

Foster to AdoptAdopt

Name*

Home Phone*

Format: (000) 000-0000.

Work Phone:

Cell

Email*

example@example.com

Address*

Address

Street Address Line 2

City

Postal Code*

Age*

Reference 1 Name:*

Reference 1 Contact Number:*

Format: (000) 000-0000.

Relationship to Reference 1:*

Example: Coworker, friend, veterinarian

How long have you known Reference 1:*

Reference 2 Name:

Reference 2 Contact Number:

Format: (000) 000-0000.

Relationship to Reference 2:

How long have you known Reference 2:

Reference 3 Name:

Reference 3 Contact Number:

Format: (000) 000-0000.

Relationship to Reference 3:

How long have you known Reference 3:

How many adults live in your home*

How many children*

Ages

Is anyone allergic to animals?*

Where will the animal be kept?*

What type of home do you live in?*

Do you Rent or Own your home?*

RentOwn

If renting, do you have permission from your landlord to have a pet?

YesNo

Please attached signed agreement OR provide Name of Landlord below

Phone number for Landlord

Current Pets in your home:

Rows	Type of pet	Name of pet	Age	Spayed/Neutered	Vaccines up to date?

Is there a specific pet of ours that you are interested in adopting?*

If Yes, why do you think this animal will make a good addition to your home?

Have you ever surrendered or returned a pet to the breeder/pound or SPCA? If so, what were the circumstances?*

Are you prepared to make a lifelong commitment to a new pet? (Dogs/Cats can live 16+ years or more)*

Have any of your pets had a litter of puppies or kittens?*

Have you ever given a pet away? if so why?*

What will you do with the pet if you move?*

Do you have the time to care and train a pet? (i.e. feeding 4 times a day, potty breaks/litter training, behaviour issues. It may take a fair amount of time for your new pet to adjust to its new home)*

Do you have a safe space to keep the pet if you can't watch it?*

Have you chosen a vet to use in your area? If yes who?*

Are you willing to spay/neuter your pet?*

YesNo

Are you aware of the cost of spay/neuter*

YesNo

How much do you estimate it will cost?*

Where did you get your pricing from?

Are there any bad dog/cat habits that you cannot tolerate?*

What are the traits you most desire in your dog/cat?*

Is this dog/cat a gift? If so, who for?*

What ages of dog/cat are you interested in?*

Puppy/KittenAdult Dog/CatSenior Dog/Cat (8+)

How will your new pet spend its days? (check all that apply)*

How will your new pet spend its nights? (check all that apply)*

I prefer a pet whose energy level is*

HighMediumLow

The noise/activity level in my home is usually*

LowMediumHigh

How many hours do you need your pet to tolerate being home alone in a day?*

If the pet has behaviour problems what will you do about it? Will you seek out assistance?*

Do you have yard or place where your dog can use the bathroom outdoors?

Is your yard fenced?

YesNo

How high is the fence?

Does your yard have an escape proof gate?

YesNo

Have you researched the breed(s)?

YesNo

Do you understand and accept the exercise requirements and health issues inherent to the breed(s)? Explain:

Are you willing to enroll in puppy/dog training classes when available?

YesNo

Any other information that will support your application?

In accordance with Town Bylaws, 1957/ADMIN/05, dogs are to be kept on leash and licensed. Dog licenses must be obtained before any dog (6 months of age and over) leaves the Hay River Animal Shelter. Licenses are registered through the Town Hall. If you are adopting a puppy under the age of 6 months, we will be doing follow up calls to ensure your dog has been licensed and spayed or neutered. Dogs that have been spayed or neutered (Veterinary proof required) will receive a lifetime tag from the Town of Hay River at NO charge. If you cannot provide proof of spay or neuter the cost is $25 per year to register.

All of the information I have given above is true and complete. The animal will reside in my home as a lifetime companion. I will provide him/her with adequate food, water, shelter, training, affection and regular vet visits. If the animal I wish to adopt is not spayed or neutered, I agree to have this done within 4 months of the adoption. The Hay River Animal Shelter will be doing follow ups and require proof of spay or neuter.

I give permission to the Hay River Animal Shelter to verify any information that I have given on this application. I understand that this application must be approved by the Hay River Animal Shelter Adoption Committee, and full payment must be received before I take possession of any animal. If for some reason this agreement is cancelled by me within 7 days, I am entitled to a full refund.

By signing below I am in full agreement with the above terms of adoption and once the animal is transferred into my care I have full responsibility for said animal. The Hay River Animal Shelter is in no way liable or responsible for any damage, accident or injury resulting from the placement of an animal into my household.

IF FOR ANY REASON THIS ADOPTION DOESN’T WORK OUT YOU ARE REQUIRED TO CONTACT US FIRST TO SURRENDER THE ANIMAL

Applicant Signature*

Date*

Date

Thank you for completing this application. This information will help us match you with the right pet for your family. We don’t necessarily take the first application for an animal; we strive to find the best suited home for each of our animals in our care.

It may take 7 business days for your application to be processed and we ask for your patience while we process each application.

Hay River Animal Shelter Adoption Application

Personal Information

References

About your home

Dog Related Questions: