Adoption Application
Name
Phone Number (no dashes)
Address
City
State
Zip Code
E-Mail
Place of Employment
Work Phone Number (no dashes)
Best time to call
Home or Work
Type of pet to adopt
Dog
Cat
Other
Name or breed interested in
Do you own or rent your home?
Do you have permission from landlord?
Landlord's name
Landlord's phone number (no dashes)
How long have you lived at this address?
Previous address if less than 1 year
Do you have a fence?
Fence Type and Height
Does fence completely enclose yard?
Names & ages of everyone living in house
Do all family members agree to adoption?
Regular visitors (human or animal)
References
Dogs/cats owned in the last 10 years
Where will new pet stay?
Inside
Outside
Mostly Inside
Mostly Outside
Name, species, age, sex & breed of pets
Are pets spayed or neutered?
Do you have a regular veterinarian?
Vet or Clinic Name
Vet address
Vet phone (no dashes)
How long have you been with this vet?
If you move, what will happen to pet?
Daily time with pet
Work hours
Activities interested in
Describe your ideal pet
Why did you choose this pet?
List plans for pet: companion,gift,etc.
Companion
Gift
Mouser
Guard
Hunting
Obedience
Herding
Agility
Other
Size preference of full grown dog
Daily hours you will spend with pet
Where will pet spend the day?
Loose indoors
Crate
Basement
Garage
Fenced Yard
Kennel
Other
Where will pet spend the night?
Loose indoors
Crate
Basement
Garage
Fenced Yard
Kennel
Other
This pet must be spayed/neutered.
I understand this pet must be s/n
Do you commit to provide proper care?
Budget for care & nutrition of pet
Can HSYC visit your home?
How did you hear about us?
Have you adopted from a shelter before?
Name of shelter/rescue group
Are you over 21 years of age?
Name & phone # of parents if under 21
Drivers License number
Certification
The above info is true and complete
Name of Applicant