Hope Lives Here Adoption Application

Hope Lives Here Adoption Application
Date

MonthDayYear
Application for (Name of Dog/Cat(s))
Applicant Information
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail
Phone Number

Area CodePhone Number
Are you 18 years of age or older ?
Preferred method of contact
Are you
On average, how long are you away from home on a daily basis?
Adoptive Home Information
Do you live in
Please describe your home type
Do you own or rent your home?
Please upload landlord approval for pets.

Upload a File

Cancelof
How long have you resided in your home?
How close is the nearest main road/highway to your home?
Do you have a fenced yard? (applicable for dog's only)
Please indicate fence height
Please describe your yard
If available, please include pictures of your yard

Upload a File

Cancelof
Adoptive Home Resident Information
Number of Adults (over 18 years old))
Number of Children (under 18 years old)
Are all residents in agreement regarding the adoption?
If no, please explain
Resident Pet Information
Have you had pets before?
If they no longer live with you, please provide details
Do you currently have pets?
Number of current resident pets
Resident Pet #1 Information
Pet Type
Age
Breed
Spayed/Neutered?
Resident Pet #2 Information
Pet Type
Age
Breed
Spayed/Neutered?
Resident Pet #3 Information
Pet Type
Age
Breed
Spayed/Neutered?
Resident Pet #4 Information
Pet Type
Age
Breed
Spayed/Neutered?
Current Veterinary Clinic
Address

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number

Area CodePhone Number
Current Veterinarian Name

First NameLast Name
Adoptive Home Preferences and Suitability
What Age of dog/cat are you Looking for?
What activity level are you looking for in a new dog/cat?
Where would the dog/cat be when you are home?
Where would the dog/cat be when you are at work?
While outside for a period of time would the dog be supervised? (Cat's not permitted outside)
Please describe how the dog woud be secure while outside (Cat's not permitted outside)
What would you do with your dog/cat if you were on vacation?
What would you do if you were unable to keep your dog/cat?
If you were forced to find a new residence what would you do with your pet(s)?
References
Reference #1 Name

First NameLast Name
E-mail
Phone Number

Area CodePhone Number
Relationship to you
Reference #2 Name

First NameLast Name
E-mail
Phone Number

Area CodePhone Number
Relationship to you
Reference #3 Name

First NameLast Name
E-mail
Phone Number

Area CodePhone Number
Relationship to you
Have you ever been charged or convicted with any criminal offence relating to animals or children?
Please describe details
*** If you don’t receive a confirmation email that we’ve received your application please send an email to info@hopeliveshererescue.com
Should be Empty:

Hope Lives Here Adoption Application

Applicant Information

Adoptive Home Information

Adoptive Home Resident Information

Resident Pet Information

Adoptive Home Preferences and Suitability

References