Clone of Adoption Form

Homeward Bound Schnauzer Rescue - Adoption Form
You will receive an email copy of this submission.

Upon receipt of your application, the Homeward Bound team will process your application utilizing publicly-accessible databases, and by contacting the references you provide. We aim to ensure the right fit with the animals in our care. Only successful applicants will be contacted; however, we will keep good candidates on file for future reference.
Name*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Format: (000) 000-0000.
E-mail Address*
example@example.com
Name of pet you're interested in adopting*
How many hours would the pet be alone?*
Please list the full names of all adults in the home, ages, and phone numbers:
Also include occupation(s) and phone number(s)
How many children live in the home?*
Ages of Children:
Do you rent or own?*

RentOwn
Landlord Name

First NameLast Name
Landlord Phone Number
Format: (000) 000-0000.
Does the lease allow the type of pet you're interested in adopting?

YesNo
Housing Type*

Single Family HouseMulti Family HouseApartmentCondominiumMobile HomeLive with Friends/RoommatesOther
Type of Yard*

Unfenced YardFenced YardNo Yard
Length of time at current address*
i.e. 3 years, 6 months, several weeks
Are any members of your family allergic to animals? *

YesNoUnknown
Does everyone in your household agree with adopting this pet?*

YesNo
What is the activity level in your home?*

Quiet- 2 or less adults/seniors, no children, applicant home most days.Calm- Applicants often home, 3 or less family members residing in homeModerate-Applicants work typical schedule ( 5 days per week home wknd)Active-Frequent visits by friends and family, multiple children other pets.Other
Other Pets in Home*

NoYes
List Pet Names, Ages, and Breeds
Veterinarian
Name of business
Name of Veterinarian

First NameLast Name
Veterinarian Phone Number
Format: (000) 000-0000.
Are all of your pets up to date with vaccines?

YesNo
Are all of your pets spayed/neutered?

YesNoUnsure
If you currently own a dog, is it on heartworm preventatives?

YesNo
How much time do any dogs in your home spend outdoors?
Please provide TWO non-family member personal references. References List*
Why are you interested in adopting a pet at this time?*

Companion for myself and familyCompanion for another petBreedingOther
What type of personality and activity level would you prefer the new pet to have? Please describe.*
Who will be primarily responsible for the care of this pet?*
What type of food will you feed this pet and how often?*
How many hours per day will this pet be without companionship?*
Where will the pet sleep at night?*
Where will you keep your new pet?*

Outside only on leashTie-out Outside only when people are homeElectric Fence- outside only when people are homeOutside only when people are homeOutside anytime including when away from homeInside all the time, other than while on walks.Other
Do you think your pet should have a yearly physical exam?*

YesNoNot Sure
Are you planning to start a family or add to your family?*

YesNoNot Sure
How much would you estimate Vet expenses to be for one year?*
How much would you estimate food and supply expenses to be for one year?*
How do you plan to exercise your pet?*
What arrangements would you make to care for your dog when you go on vacation?*
Describe under what circumstances might you decide not to keep your dog? ( check all that apply)*

New JobNew BabyChewing/ScratchingProblem With Dogs HealthProblem With Dogs BehaviorConflict With Other PetsIllness/AllergiesMovingFinancial IssuesOther (explain)
Have you ever adopted a pet from a Shelter or Rescue before?*

YesNo
Have you ever surrendered an animal before ( to a shelter, rescue, friend) *

YesNo
If yes, please explain
Have ever taken a dog to obedience training?*

YesNoN/A
If you are planning to train your pet, please descrbe your training plan:
(i..e. type of training, length of training)
Have you ever crate trained a dog?*

YesNoN/A
Prior to adoption, would you allow us to perform a home visit?*

YesNo
If No, Please Explain
Have you applied to adopt from us before?*

YesNo
How did you hear about our organization?*
By completing an adoption application, you are providing consent to Homeward Bound to screen your application, to contact your references (including your veterinarian).

By typing YOUR INITIALS below, you certify that, to the best of your knowledge, all statements made above are true and correct.
Enter your initials in the text box below:*
Homeward Bound provides assistance to animals who are often in difficult circumstances or require extensive medical care. If you are able, please consider making a tax-deductible donation to help us (link on confirmation page). There is no obligation to do so, but please know we are grateful for all the assistance we receive. Thank you!
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Homeward Bound Schnauzer Rescue - Adoption Form