HDPR Pet Adoption Application Form

FILLING OUT AN APPLICATION DOES NOT GUARANTEE ADOPTION, NOR DOES IT OBLIGATE YOU TO ADOPT.
SOME PETS HAVE SPECIAL NEEDS, THEREFORE NOT ALL PETS ARE SUITABLE FOR ALL HOMES
ALL APPLICANTS ARE SCREENED AND A HOME VISIT IS REQUIRED
THERE IS A DONATION REQUIRED TO ADOPT
MUST BE 21 YEARS OR OLDER TO ADOPT
IF OVER 65, AND THE PET IS UNDER 5YRS OF AGE, A FAMILY MEMBER MUST ALSO APPLY AS A “COMMITTED GODPARENT”

ALSO...

PLEASE BE AWARE THAT YOU MUST FILL IN ALL THE STARRED FIELDS IN ORDER TO SUBMIT YOUR APPLICATION.
PLEASE BE AWARE YOU MUST SIGN YOUR APPLICATION BEFORE SUBMITTING IT.
PLEASE DO NOT FORGET TO PRESS SUBMIT!

Pet of Interest's Name*

Why are you interested in this pet/breed?*

Your Full Name*

First NameLast Name

Your Age*

Your Occupation*

Phone Number*

E-mail*

example@example.com

Marital Status*

If Married or have a Partner Name of Partner

First NameLast Name

Partner Age*

Partner's Occupation

Partner's Phone Number

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

How long have you lived at this address?*

Do you have any pet restrictions?*

OwnRentLive with ParentsOther

If Renting: Please indicate landlord contact information

How many hours a day do you work outside the home?*

Busy/NoisyModerate Comings/GoingsQuiet with Occasional Guests

Please list name, age, gender of each child living in the home:

Do you have children that frequently visit?What are their Ages?

YesNo

Please list: Name, breed, gender of each pet you currently own/have owned in the past 5 years. If none, fill in none.*

What happened to the pet(s) if not still living with you? If they have died, advise the cause and age at time of death please.

Are they or were they all spayed/neutered?

Are they or were they all current on their Vaccines?

Do you or did you use Flea/Tick/Heartworm prevention? If yes, what kind?

Have you ever surrendered a pet? Give Details.*

YesNo

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?

If you had to move to a place that didn’t allow pets, what would you do with your adopted pet or current pets?*

What experience with Pets do you have?*

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

YesNo

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? *

Do you have a dog/cat door to outside? If so please explain.*

Type of cat desired? (friendly, playful, sweet, calm)*

Specific breed?*

Where will the cat sleep?*

Where will you put its litter box?*

Do you have a screened patio/balcony/pool? If yes, specify.*

YesNo

It will be an indoor catIt will be an outdoor catIt will be both indoor and outdoor cat

YesNo

Reference #1: Full Name*

First NameLast Name

Relation to applicant(s):*

E-mail

example@example.com

Phone Number*

Reference #2: Full Name*

First NameLast Name

Relation to applicant(s): *

E-mail

example@example.com

Phone Number*

Reference #3: Full Name*

First NameLast Name

Relation to applicant(s):*

E-mail

example@example.com

Phone Number*

Veterinarian Office Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number*

THE DONATION REQUIRED TO ADOPT VARIES BASED ON BREED, AGE, TEMPERMENT AND LENGTH OF TIME CAT HAS BEEN IN OUR CARE.YOUR DONATION IS SOLELY USED TO RESCUE AND CARE FOR OTHER ABANDONED PETS. *** THANK YOU FOR BEING AN INTEGRAL PART OF SAVING THEIR LIVES!!! ***

YesNo

If yes, please fill in amount pledged monthly/yearly.

How did you hear about Happy Days Pet Rescue?*

YesNo

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).

YesNo

Date*

MonthDayYear

Email

example@example.com

Type your name*

Signature*

ARE YOU INTERESTED IN A SPECIFIC PET?

YOUR INFORMATION

SPOUSE OR PARTNER INFORMATION

RESIDENCE INFORMATION

HOUSEHOLD INFORMATION

CURRENT OR PRIOR PETS HISTORY

HOME SAFETY / ACCOMODATIONS

ANIMALS IN THE HOME

INFORMATION SPECIFIC TO CATS

COMMITMENT INFORMATION

REFERENCES

VETERINARIAN INFORMATION

DONATION INFORMATION

OTHER

AGREEMENT INFORMATION