Adoption Application Form

Information about the Pet(s) of Interest

Type of pet you want to adopt:

Name Description

Why this pet?

Contact information

Full Name* Email*

Street Address* City*

State* Zip code*

Phone number* (daytime) Phone number (evening)

Additional information

Are you 21 or older? If not, who will be signing the foster agreement?

Occupation

Household information

Number of adults in the home Number of children in the home

Ages of the children in the home

What type of home to you live in? If other, please specify

Do you rent or own If other, please specify

Do you have written permission from your landlord to have pets in your home?

May we contact your landlord/parents?

Parent/landlord's full name Phone Number

Adoption History

Would this be your first pet? Explain

Number of pets in your home

Current pets (name, age, sex, breed)

What happened to pets you no longer have? If deceased, state cause and circumstance)

Have you ever applied to adopt a pet from HFA before? If yes, when? (MM/YY)

Have you ever asked HFA to take an animal for you?
If yes ,explain

What brand of food do (did) you feed your pet(s)?

Questions

How do you plan to introduce the new pet to your current pet(s)?

Will you spay/neuter your pet if not already done prior to adoption?

Why do you want to adopt this animal? (select all that apply)
 companion companion for other pet house pet hunting barncat/ mouser other

If other please specify
How will your new pet spend its days? (select all that apply)
 indoors outdoors crated tied outside basement garage porch yard cage barn locked in room in doghouse in person's bed

If you go away who will care for your pet?

Is someone home during the day? Explain

Are you willing to take responsibility for this pet until he/she dies of old age or illness (sometimes 10-20 yrs) even if your situation change or if you have to move?

Does any member of your household have an allergy to animals

For cats only
Will you have your cat declawed? Are your current or previous cats declawed?

What is your opinion of declawing cats?

Where will you keep the cat? Explain

For dogs only
Do you have a completely fenced-in back yard?

Fence height Fence type Does the fence have a gate?

Explain

How will you exercise the dog?

If you drive in a pickup truck, would you allow the dog to ride in the back?

Vet Reference

Vet name Phone number

Account name

Names of pets under vet care

Other references

Note: This part is optional if you have a vet reference.

Reference 1:

Name Phone number

How long have you known him/her? Type of reference

If "other" please specify

Reference 2:

Name Phone number

How long have you known him/her? Type of reference

If "other" please specify

Agreement

I agree to allow HFA to visit my home by appointment as part of the application process. I give my veterinarian permission to disclose information about my pets, my account, and myself. If I adopt a pet, I will spend the time and money necessary to maintain its health and well-being. I will spay/neuter the pet if it has not already been done prior to adoption. I attest that all the information provided in this application is true and complete to the best of my knowledge. If any of the information changes, I will notify HFA as soon as I can.

Check here if you accept these terms.

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