Adoption Application

Allow up to 3 weeks for a volunteer to contact you via email regarding your application. Thank you!

Applicant's Name*

First NameLast Name

Co-Applicant's Name

First NameLast Name

Age*

Age

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number - Cellular*

Format: (000) 000-0000.

Phone Number - Alternate Cellular

Format: (000) 000-0000.

Phone Number - Home/Landline

Format: (000) 000-0000.

Email*

Please provide an email address that you check regularly as this is how we will contact you. Don't forget to check your junk/spam folder as well.

Applicant's Employer*

Co-Applicant's Employer

YESNO

What dog are you applying for?*

Which dog are you applying for? (If not applying for a specific dog, type “open to right match”*

YesNo

Due to the overwhelming influx of apps received for this precious furbaby we can no longer accept any at this time. If you would like to continue your app and be added to our general waiting list please select 'Other' from the drop down above.

Thank You!!

If not listed above please type name here*

What age dog are you looking for?*

What gender?*

What size?*

Do you have a color preference or any other specific requirements?*

What traits are you looking for in your new dog, i.e. playful, protective, high energy, "couch potato," etc.*

Please list all people living in the household other then yourself. Include name, relationship, gender, and age.*

YesNo

Please list their age and relationship to you.*

YesNo

If yes, which animals*

Do you live in a:*

Select the type of property in which you reside

OwnRentLive with ParentsOther

Please indicate landlord contact information. A copy of your lease/rental agreement may be required. If you checked "other," please explain.*

How long have you lived at this address?*

PhysicalElectricNeither

Please describe the type of fence, height, etc.*

If you do not have a fence, how will you handle potty time and exercise?*

How do you plan to exercise the dog, i.e. on lead, off lead, dog park, etc.*

YesNo

Who will be the dog's primary caretaker?*

How many hours a day and days per week will the dog be left alone?*

When no one is home, where will the dog be kept?*

Where will the dog spend the majority of his/her time when you are home?*

Where will the dog sleep at night?*

What are your thoughts regarding pets on the furniture?*

If you travel, who will take care of your pets, or would they travel with you?*

YesNo

Please list all pets living in your home. Please include: species, name, breed, age, if altered, sex, up-to-date on vaccines, and on heart worm preventative.*

Please describe your relationship with your pet(s). We ask that you include as much detail as possible.*

YesNo

Please identify each animal.*

Please list any pet you have had in the last 10 years. What happened to the pet(s)? If deceased please give circumstances of death.*

YesNo

If yes, please explain.*

Would you ever give a pet away? Under what circumstances? Where would it go?*

Are you willing, able, and prepared to provide the full cost of care for this dog, including routine medical care, food, toys, grooming and training?*

What would you do if your pet needed emergency medical care? What would you do if you could not afford it? There is no right or wrong answer, just something you need to think about.*

What is the maximum number of pets you intend to have at one time?*

Do you foresee yourself adopting additional pets and if so what kind?*

Have you and your family discussed the responsibility, cost, time, and effort that a dog will require?*

YesNo

Please give details.*

What circumstances or behaviors might cause you to return a dog to us?*

YesNo

Would you consider a special needs dog? A special needs dog may have a handicap, short term health issues, long term health issues, or may be a senior.*

YesNo

Please explain.*

YesNo

If so, please explain.*

If you are applying for a puppy or an untrained dog, are you prepared to house train? What house training methods will you use?*

Will you crate train?*

Are you prepared to enroll your new pet in obedience training? If so, where? It is recommended that adopters enroll in a training course with their new dog in order to help form that special bond and let the dog know that you are the leader.*

Please provide your Veterinarian's name, email and phone number. If you do not currently have pets, please provide the information for your previous veterinarian(s). Because of HIPPA regulations, PLEASE CONTACT YOUR VETERINARIAN TO AUTHORIZE THEM TO SPEAK TO HOUSE OF HOPE REGARDING YOUR PET'S VETTING HISTORY. *

Please provide the NAME and PHONE NUMBER of THREE (3) personal references - DO NOT USE FAMILY MEMBERS. PLEASE LET REFERENCES KNOW SOMEONE FROM HOUSE OF HOPE WILL BE CONTACTING THEM BY PHONE CALL OR TEXT. *

I understand

By sending this electronically, I acknowledge that I have completely read this questionnaire and comprehend it fully. I also certify that the above is true and accurate to the best of my knowledge. I also understand that the above information will be verified.

I understand that applying does not ensure approval and that untruthful answers, false or misleading information, or failure to comply with the requirements of this application can result in rejection of my application and/or may be considered justification for the removal of my adopted dog if discovered at a later date.

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Your name*

Co-Applicant name (if applicable)