Pet Adoption Application Form

How did you hear about Happy Days Pet Rescue?

Full Name*

First NameLast Name

Age

E-mail*

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number - Home

Area CodePhone Number

Phone Number - Cellular

Area CodePhone Number

Phone Number - Work

Area CodePhone Number

Do you live in a:

Do you:

OwnRentLive with ParentsOther

If Renting: Please indicate landlord contact information

Household Setting

RuralSuburbanUrban

Describe your Homes Activity Level

Busy/NoisyModerate Comings/GoingsQuiet with Occasional Guests

Please List all People Living in the Household (Include Name, Relationship, Gender and Age)*

Does Anyone in your Household have Allergies to Animals?

YesNo

Are all members of your Family agreeable to Adopting a Pet?

YesNo

Please List any Pets you have (Please include Name, Breed, Age, Altered, Gender, UTD Vaccines, Heartworm, )*

Have you ever surrendered a pet? Details

We cannot guarantee a pet to be housebroken, are you equipped to train with love and patience?

YesNo

How will you handle vacation and time away from your Pet. Who will watch it while away?

Why are you interested in this breed?

You understand a home check will be performed before final approval and adoption?

Have you had any experience with with an emotionally or physically neglected or abused Pet?

YesNo

If Yes please explain

Are you willing to use a crate for a Pet if recommended?

YesNo

Do you have a fenced yard?

YesNoPartial

If fenced, please give details on height, material, # of gates, are gates locked or lockable?

Are you willing to put up required fencing if you are not already set up. Are you allowed to modify property to add needed fencing? Can you put in Dig Guards?

What experience with Pets do you have?

How many hours in a day would the Pet be left alone?

What are your plans to exercise or spend quality time with your Pet?

Martial Status/kids/ages/whoswill be living with the Pet

Please list 3 personal references with names, addresses, phone numbers and how related. We prefer it not to be all relatives. Are you ok with this?

YesNo

Vet Reference: Full Name*

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number

Area CodePhone Number

Reference #1: Full Name*

First NameLast Name

Relation to applicant(s):

E-mail

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number

Area CodePhone Number

Reference #2: Full Name*

First NameLast Name

Relation to applicant(s):

E-mail

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number

Area CodePhone Number

Reference #3: Full Name

First NameLast Name

Relation to applicant(s):

E-mail

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number

Area CodePhone Number

By sending this electronically, I acknowledge that I have completely read this questionnaire and comprehend it fully.

I understand that applying does not ensure approval and that untruthful answers or failure to comply with the requirements of this application can result in the forfeiture of any Happy Days Pet Rescue animal fostered/adopted by me.

I certify that the above information is correct, and I understand that the information will be verified.

I understand that by submitting this form electronically, I agree to release and covenant to hold harmless Happy Days Pet Rescue and it's members from any claims, damages, costs, or actions incurred because of the care or actions of the adopted/fostered.

I accept full responsibility for the Pet(s) actions at all times, and release Happy Days Pet Rescue any liabilities or damages that may be incurred because of fostering/adopting such dog(s).

I agree to have Happy Days Pet Rescue complete reference call checks and conduct a home visit inspection to be able to approve my foster/adoption application.

I agree that if I'm unable to foster/own the Pets(s) anymore that I will return the Pet(s) to Happy Days Pet Rescue try to give Happy Days Pet Rescue a 2week period to try and find another suitable foster/adopter for the Pets(s).

Date

MonthDayYear

Your name*

E-mail