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!
ARE YOU INTERESTED IN A SPECIFIC PET?
Pet of Interest's Name*
Why are you interested in this pet/breed?*
YOUR INFORMATION
Your Full Name*

First NameLast Name
Your Age*
Your Occupation*
Phone Number*
Format: (000) 000-0000.
E-mail*
example@example.com
Marital Status*
SPOUSE OR PARTNER INFORMATION
If Married or have a Partner Name of Spouse or Partner

First NameLast Name
Partner Age*
Partner's Occupation
Partner's Phone Number
Format: (000) 000-0000.
RESIDENCE INFORMATION
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?*
Do you line in a:*

HouseTownhouseCondoApartmentDuplexMobil HomeOther
Do you:*

OwnRentLive with ParentsOther
If Renting: Please indicate landlord contact information
HOUSEHOLD INFORMATION
How many hours a day do you work outside the home?*
Describe your Homes Activity Level*

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?
Does Anyone in your Household have Allergies to Animals?

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

YesNo
CURRENT OR PRIOR PETS HISTORY
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.*
HOME SAFETY / ACCOMODATIONS
Do you understand a home check will be performed before final approval and adoption?*

YesNo
ANIMALS IN THE HOME
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?*
Have you had any experience with with an emotionally or physically neglected or abused Pet?*

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

YesNo
How many hours in a day would the Pet be left alone?*
Do you have a dog/cat door to outside? If so please explain.*
INFORMATION SPECIFIC TO CATS
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.*
Will the cat be allowed outdoors?*

YesNo
Will you declaw the cat (Surgically remove its nails?)*

YesNo
Will it be an indoor cat, an outdoor cat, or both in and out?*

It will be an indoor catIt will be an outdoor catIt will be both indoor and outdoor cat
COMMITMENT INFORMATION
Indoor, spayed/neutered cats/dogs can live an average of 15-20 years. Are you able and prepared to make a lifetime commitment to financially and physically care for this adopted pet for the durationof it’s life?*

YesNo
If for any reason the dog/cat does not work out for your family, you are unable to keep the dog/cat, or a vet states the dog/cat is very sick and you cannot afford the treatment, do you agree to contact and return the dog or cat to Happy Days Pet Rescue immediately?*

YesNo
REFERENCES
Reference #1: Full Name*

First NameLast Name
Relation to applicant(s):*
E-mail
example@example.com
Phone Number*
Format: (000) 000-0000.
Reference #2: Full Name*

First NameLast Name
Relation to applicant(s): *
E-mail
example@example.com
Phone Number*
Format: (000) 000-0000.
Reference #3: Full Name*

First NameLast Name
Relation to applicant(s):*
E-mail
example@example.com
Phone Number*
Format: (000) 000-0000.
VETERINARIAN INFORMATION
Veterinarian Office Name*
Phone Number*
Format: (000) 000-0000.
DONATION INFORMATION
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!!! ***
Does your company offer a “gift matching program”?*

YesNo
Would you be interested in joining as a monthly supporter?*

YesNo
If yes, please fill in amount pledged monthly/yearly.
OTHER
How did you hear about Happy Days Pet Rescue?*
By signing this application, you agree to random wellness checks and visits for the adopted pet to ensure its safety, well being and care. If the animal is not being taken care of by our standards, we have the right to remove the animal from your possession. Do you fully understand this.*

YesNo
AGREEMENT INFORMATION
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 Pet(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).
Do you agree you have read the above agreement information above and that the information you provided in this application is true?*

YesNo
Do you agree that if any information is found to be false we have the right to reclaim the adopted pet from you?*

YesNo
Date*

MonthDayYear
Email
example@example.com
Type your name*
Should be Empty:

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