HFLR Adoption Application

HOPE For Love Rescue

Adoption Application
Name of Dog(s) Your Applying For:
Full Name*

First NameLast Name
Your Age
Primary Phone Number*

Area CodePhone Number
Secondary Phone Number

Area CodePhone Number
E-mail*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Type of residence:*

HouseApartmentCondoMobile HomeTownhouseRenting a Room
How long at present address?*
Do you:*

OwnRent
If Renting, Provide Lanlord's Full Name & Phone Number & Email Address:
Please list name & age of each person living in household, including yourself:*
Are there any Restrictions from your Landlord, if renting, regarding pets?
Is anyone allergic to animals?*

YesNo
Is everyone in the household in agreement to adopting?*

YesNo
Do you have plans to move in the near future?*

YesNo
If you did move, what would you do with animals?*
Do you have a fenced yard?*

YesNo
Type of fencing?*

WoodChainVinylOther
How tall is fence?*

4 feet6 feet8 feetnone
Do you have a pool?*

YesNo
Please describe the neighborhood you live in. Ex: town or country, quiet or busy, major roads; traffic, are there a lot of children, dogs etc...*
Please list all animals you currently own by breed/sex/gender/short description of dogs personality & temperment. Any dislikes your current dog(s) might have, so we can better match your family to the right dog:
Dog #1
Dog #2
Dog #3
Do you have cats*

yesno
If yes, do they stay

indoorsoutdoorsboth
Do you have*

chickenslivestockany other animalsnone
Are all your pets spayed & neutured*

yesno
If no, please explain why*
How many pets have you owned in the last ten years?*
Where are those pets now?*
Have you ever had to give up a pet?*

yesno
If yes, please explain circumstances*
N/A if no
Have you ever adopted a pet before?*

yesno
If yes, who did you adopt through?*
N/A if no
Why do you want to adopt the Dog your applying for?*
What is your favorite and least favorite thing about Dogs?*
What is your experience with Dogs?*
What is Generally your Sex Preference in Dogs?

MaleFemaleNever Had a Preference
What has Generally been your Breed Mix & Personality Preference in Dogs?
Who would be responsible for your Adopted Dogs daily care?*
How many hours a day would your Adopted Dog be left alone?*
Where will the Adopted Dog stay when alone?*
Where will the Adopted Dog stay at night?*
How active is your family*

very activesomewhat activenot very activecouch potatoes
Will the Adopted Dog be included in family activities?*

yesno
Does your family participate in water activities?*

yesno
Where will the Adopted Dog stay during family trips/vacations?*
Please provide your current vets information.
Vet's Name*
Vet's Phone Number*
Are you able to afford unexpected medical bills for a Dog?*

yesno
What do you believe an average yearly cost for medical care to be?*
What do you believe an average monthly cost would be to feed the Dog you've chosen?*
What other costs do you believe there will be with a Dog?*
What Food will you feed your Adopted Dog?*
How will you exercise your Adopted Dog?*
Are You Willing to Work on Any Problems that Arise?

YesNoDepends
What Problems are You NOT Willing to Work with?

AggressionWashroom ProblemsHighly Active DogExtra Needed TrainingOtherDecompression/Adapting
I would Never Give Up On or Give My Adopted Dog Away?

Never Give UpNot SureI Would Give Up if I Had To
Will you allow HFLR to do a home visit prior to and after adoption?*

yesno
Please provide two personal references.
Reference #1 Name*
Reference #1 Phone Number*
Reference #2 Name*
Reference #2 Phone Number*
Any other comments or information you would like us to know in considering your adoption application?
By submitting this form, I hereby certify that all information provided by me is true and complete. I understand that any misrepresentation of information may result in adopted animal being confiscated.
Should be Empty:

HOPE For Love Rescue