AAHA Adoption Application 2023

Animal You Are Applying For:*

Date*

Date

The following information is requested so that we can assist you in the selection of a new dog. Our goal is to place animals in loving, safe homes with compassionate people who will make lifelong commitments to them by accepting them as a member of their family. The adoption process is designed to help determine the best match between the pet and the lifestyle of the adopter. This also enables us to determine if the adoption is in the best interest of the pet.

Before completing this application please understand that we are ALL volunteers that have families and work full time jobs so please be PATIENT!!

In order to adopt an animal you must:
> Preferably own your own home
> Be 21 years of age or older
> Have identification showing your present address

Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Email*

example@example.com

Home Phone Number*

Area CodePhone Number

Work Phone Number

Area CodePhone Number

Cell Phone Number*

Area CodePhone Number

How did you find this animal?*

How soon are you looking to adopt? *

How many people in your household? *

#Adults/#Children (Ages of Children)*

Does anyone in the home have allergies to pets?*

Employer

Do you work outside the home?*

Is anyone home during the day? *

How long will the animal be alone each day? *

Is this your first experience owning a pet? *

Have you ever had to give up a pet? *

Do you currently own any pets?*

Why do you want to adopt this animal?*

Do you plan to crate train your pet?*

Where will the animal sleep? *

Do you have a fenced-in yard?*

What type of exercise are you planning to provide the animal and how often?*

How many pets have you owned in the past 5 years?*

Please list each pet and the status of each pet you have owned in the last 5 years, if not currently living with you

If you are interested in adopting a puppy, what is your prior puppy experience?

What do you consider a reasonable amount of time to allow a new animal to adjust to your home? *

What would you consider doing if the animal was still having trouble adjusting after that time? *

VETERINARIAN REFERENCE
Please call your Veterinarian in advance to give them permission to speak with us, in case they are a practice that requires Client Consent (Leave the next two fields blank if you don't have a veterinarian)

Veterinarian

First NameLast Name

Veterinarian Phone Number

Area CodePhone Number

PERSONAL (NONRELATIVE) REFERENCE #1

Personal Ref Name (1)*

First NameLast Name

Personal Ref Phone Number (1)*

Area CodePhone Number

Personal Ref Email (1)*

example@example.com

PERSONAL (NONRELATIVE) REFERENCE #2

Personal Ref Name (2)*

First NameLast Name

Personal Ref Phone Number (2)*

Area CodePhone Number

Personal Ref Email (2)*

example@example.com

When you push the Submit button, you agree to the following:
> To keep the adopted animal current on health check-ups and vaccinations
> Purchase a properly fitted collar and license with your phone number
> Agree not to tie or chain the pet as a primary means of confinement
> Agree that your pet will live in the house with the family and not be an outside pet
> Be able and willing to provide standard and emergency medical care. Be aware that expenses for an animal usually run about $700/year. Medical conditions or emergencies can cost much more
> Provide professional training when necessary to correct behavior problems