Adoption Application

Application for Adoption

We're so excited to help you find your new family member! We have some amazing rescue pups being fostered in TX, AR, CO, OK, and IA! We can help with tranport to various locations in the US and near Canada.
About You

Name(s), Contact Info, and Perferred Communication Methods
Name of Primary Adopter*

First NameLast Name
Primary Adopter - Mobile/Cell Phone*
Format: (000) 000-0000.
Primary Adopter - Email*
Name of Secondary Adopter (if applicable)

First NameLast Name
Secondary Adopter - Mobile/Cell Phone (if applicable)
Format: (000) 000-0000.
Secondary Adopter - Email (if applicable)
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Home Phone
Format: (000) 000-0000.
Your Age(s). If application, include the secondary adopter's age as well.*
Occupation
Select your preferred method of communication:
We use video calls for virtual home visits and dog meet & greets. What video call options would you prefer to use (if applicable)? Please select all that apply:

FaceTime (iPhone users)Facebook Messenger (Facebook users)WhatsAppGoogle MeetZoomDuoOther
About Your Living Arrangements

Please note that many rental contracts as well as homeowner associations for owned condominium or townhomes have breed and/or weight restrictions. Therefore we must verify current rules/regulations with them before proceeding with the application process.
Do you:*
Type of Residence:*
If Other, please specify:
If RENT, please provide your landlord name, phone and/or email. Enter N/A if you do not rent.*
If OWN a single-family home, condominium or town home in a community with any type of HOA, please provide the HOA name, phone and/or email. Enter N/A if you do not own. *
How long at your current residence?*
Is there a fenced yard?*
Is there a busy street nearby?*
Preferences

Please provide more details on what would make for an ideal match in a dog based on your preferences and homelife!
Name of dog(s) you are interested in, if applicable. *
Our "match" volunteers will be able to assist you in exploring specific dogs you are interested in and/or offer options of available rescue dogs that align with your preferences and lifestyle at home.
Breed:
Do you prefer a dog that is purebred, mixed, or no preference:*
Sex (NOTE: We prefer not to place 2 Chows of the same sex in a home together. We will consider exceptions on a case by case basis):*
Desired Age:*
What is the maximum age you would consider?*
Desired Color*:*
*Chows colors are typically black, blue, cream, cinnamon, or red. Please enter "No preference" if you do not have a color preference.
Do you have objections to a home visit by a rescue person? Note that most home visits are virtual.*
Is this pet for yourself or a gift?*
Are there children in the household? (If yes, list ages and genders):*
Do you currently own any other pets? *
Do you currently own any other pets? If yes you have other pets, please list name: type of pet, breed, age, sex, and if they are spayed/neutered.*
Have you ever surrendered an animal to a shelter?*
Is there any reason that would make you give up your pet?*
Please list dogs you have owned in past 10yrs. Please list names and what happened to them. Please enter "N/A" if you have not owned a dog before.:*
Do you have a dog crate?
Where would this pet live?*
Have you ever obedience trained a dog?
If Yes, what facility or facilities have you used? If no, please enter N/A.
If desired breed is a Chow Chow, have you ever owned a Chow before or familiar with the breed? *
If desired breed is a Chow Chow, how will you groom your Chow and how often?*
Veterinarian Reference

CURRENT
Veterinarian Name / Practice:*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*
Format: (000) 000-0000.
E-mail
Veterinarian Reference

PAST
Veterinarian Name / Practice:
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number
Format: (000) 000-0000.
E-mail
example@example.com
Personal References

(a person who has been in your home and has seen how you cared for your past/current pets)
Reference#1*

First NameLast Name
Reference#1 Relationship*
Reference#1 Email*
example@example.com
Reference#1 Phone Number*
Format: (000) 000-0000.
Reference#2 (NOT A RELATIVE)*

First NameLast Name
Reference#2 Relationship*
Reference#2 Email*
example@example.com
Reference#2 Phone Number*
Format: (000) 000-0000.
List one person who would always be able to reach you, even if you moved.*

First NameLast Name
Relationship*
Email*
example@example.com
Phone Number*
Format: (000) 000-0000.
Is there anything else you would like us to know about your desire to own a rescue pet?
How did you hear about us?
If Other, please explain:
HCCC is a 501(c)(3) nonprofit organization that is entirely run by our volunteers with zero administartive costs. We're comitted to pairing you with a HCCC rescue dog that is well suited to your family through our matching process. Please select all that apply to you:*

I acknowledge adoption fees range from $300 to $450, which would contribute towards covering my dog's medical expenses - e.g., wellness exams, core vaccines, spay/neuter, heartworm test (and treatment if needed), grooming, and all other medical needs (sick exam, entropion surgery, etc.).I am interested in learning more about transport costs, which typically range from $200 - $400. HCCC volunteers can discuss transport options with me, which may invovle me driving to a nearby city to meet the transport team. Please note puppies under the age of 6 months do not go on transports for their safety and wellbeing.I acknowledge and agree that should I become permanently unable to care for my adopted pet due to incapacitation, illness, or death, I have made a legally sound contingency plan (e.g., designated a caregiver in my will or trust). I agree to list Houston Chow Chow Connection as a secondary or primary beneficiary in the event that my designated caregiver cannot fulfill their commitment. I understand that my chosen representative/caregiver will be aware of this arrangement and the proper procedures to contact Houston Chow Chow Connection.
By submitting this application, you give Houston Chow Chow Connection consent to contact the designated veterinary office for proof of medical records and / or treatment as well as contacting references.
***PLEASE NOTE: IF YOU DO NOT RECEIVE A CONFIRMATION MESSAGE WHEN YOU HIT THE "SUBMIT" BUTTON BELOW, PLEASE GO BACK AND MAKE SURE YOU HAVE FILLED OUT ALL OF THE MANDATORY FIELDS.***
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Application for Adoption

About You

About Your Living Arrangements

Preferences

Veterinarian Reference

Veterinarian Reference

Personal References