Our House of Hope Adoption Application
This is a comprehensive adoption application which may seem formal, but it is intended to ensure that the right dog is being placed with you. An improper placement, or one based on inadequate information, can end tragically for the dog and the adoptive family.Every question must be answered in order for this application to be complete and for you to be considered. All information furnished here will be kept confidential and will only be available for use by Our House of Hope. All of our dogs will be spayed or neutered prior to adoption
PERSONAL INFORMATION
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Age
*
Email
*
example@example.com
Occupation and Position Title
*
Employer Name and Work Schedule
*
YOUR FAMILY
Who is this pet for?
*
Self
Child
Entire Family
Spouse
Parent
Other
Choose One:
*
Please Select
Married
Divorced
Single
Widow
Other
If Single:
*
Please Select
Live Alone
With Family
Roommates
Other
N/A
Do you plan on adding more members to your household in the future?
*
Please Select
Yes
No
Not Sure
How many smokers live in your home?
*
Do any members of your family have any ongoing medical conditions (including allergies) that might interfere with ownership of a new dog?
*
Yes
No
If yes, please explain:
List all other members of the household where the pet will live
*
YOUR HOME
Choose one:
*
I own
I rent
It is a...
*
House
Condo
Apartment
Townhouse
Other
If renting, does your landlord and/or tenant’s association permit pets? A copy of your lease is required if you are renting
*
Yes
No
N/A
Renters: Please supply the following for verification:
How long have you lived at this address?
*
Do you have a fence attached to this address
*
Yes
No
N/A
If yes, please describe your fence:
*
If there is no fence, how do you plan for the dog to relieve itself?
Do you have a pool?
Yes, however it is fenced separately
Yes, it is enclosed in the yard where the pet can access to it
No
Do you plan to move in the future?
*
Yes
No
Not Sure
If yes, when and where to?
PET HISTORY
Have you ever tried to adopt from Our House of Hope in the past?
*
Yes
No
If yes, what happened?
Have you ever owned other pets?
*
Yes
No
If yes, please give a brief history and state what happened to it (them):
Please list all other pets currently residing in your household
*
If you have other pets, describe & explain their behavior towards people and other animals:
Are there any dogs belonging to family or friends that might be aggressive towards your dog?
*
Yes
No
N/A
If yes, please explain:
With any past or present pets, have you had any behavioral problems?
*
Yes
No
N/A
If yes, please explain:
Are you prepared to spend the time necessary to accustom other animals to the new dog?
*
Yes
No
N/A
Can you isolate the other animals if they cannot get along?
*
Yes
No
N/A
YOUR LIFESTYLE
Who will have primary responsibility for this pets’s feeding, grooming, veterinary care, etc.?
*
Does everyone in your family want a new pet?
*
Yes
No
If no, why not and what are their concerns?
How many hours a day will this pet be without people around? (be realistic)
*
If you work and are home for lunch, what is your actual time at home at lunchtime?
*
Where will your pet be kept when no people are home?
*
Where will your pet sleep at night?
*
What will you feed your pet?
*
If you are away for a few days or go on vacation, who will take care of your pet?
*
Do you have children under 7 that visit your home?
*
Yes
No
If yes, how many are there and how often do they visit?
Are you willing to attend classes to train this dog?
Yes
No
N/A
Do you intend to crate train the dog?
Yes
No
N/A
What action by the dog would lead you to discipline it (e.g. soiling, barking, biting, etc.) and how do you discipline?
*
can type n/a for exotics
ADOPTION PREFERENCES
What sex do you prefer?
*
Please Select
Male
Female
No Preference
What age do you prefer?
*
Juvenile / Puppy
Senior
Adult
No preference
Do you have a specific pet in mind?
*
Yes
No
If yes, which animal(s)?
Will you accept a dog that barks, needs housebreaking, or other obedience help?
*
Yes
N/A
No
Maybe with the following conditions:
What are your conditions if you answered maybe for the question above?
What other pets, if any, have you been considering?
HEALTH STATUS OF DOGS
All of our dogs have been examined by a veterinarian and have been spayed or neutered.
Dogs available for adoption have been provided with proper health care and adoptive families will be informed of any conditions that are made aware of to Our House of Hope.
Will you accept and treat with proper veterinary care a pet with medical problems for as long as necessary?
*
Yes
No
We expect our dogs to have an annual physical exam with immunizations, regular rabies vaccinations, and to be on monthly heartworm preventative medication.
We also expect their teeth to be cleaned as needed because periodontal disease is the #1 killer of small dogs. Grooming is also required as needed.
Do you understand that there are routine yearly costs involved for the pet and have you budgeted for these?
*
Yes
No
Have you budgeted for emergency veterinary care?
*
Yes
No
If no, please explain:
Will you have difficulty financially if you have major expenses for your pet?
*
Yes
No
REFERENCES
All references will be checked. You may be asked to provide additional references
Please provide the name and phone number of TWO non-relative character references we may contact.
*
Veterinary Reference
If you don't have a veterinary reference, please explain why:
Please provide the name, address, and phone of your pet’s groomer. If not applicable explain why:
*
VISITS
Our House of Hope requires that prospective adoptive parents visit the pet prior to the actual adoption.
Would you be willing to allow an Our House of Hope representative to visit your home prior to and/or after adoption?
*
Yes
No
If no, please explain:
Final Confirmation
Submit
Should be Empty: