Adoption Application

Transcription

1 Adopter Contact Information Co-Applicant (if applicable) Address City State ZIP Home Phone Your Work Phone Your Cell Phone Your Address Spouse s Address (if applicable) Your Occupation Spouse's Occupation (if applicable) About You Have you owned a dog before? Have you owned a Doberman before? Do you rent or own your current residence: How long at current address? Rent Own Describe Residence: House Townhouse Apt./Condo Mobile Home Other If you rent: Has a pet deposit been paid? Are there any restrictions on pet size/ breed Yes No Yes No Landlord : Landlord Phone Number: How many times have you moved in the past 5 years? Reason(s) How many people, including yourself, live in your household? What are their ages? Do you plan on moving in the next few years? Yes No Who will be primarily responsible for the dog? Is anyone in the household allergic to animals? Is everyone in the household aware of your intention to adopt a pet? Are you willing to attend a basic obedience course with your Doberman? What level of activity in a dog would be ideal for you? Explain Are you willing to let a representative of HADR visit your home? Describe any training you have had with current or past pets How do you plan on exercising the dog? Describe the causes and prevention of heartworm disease: Will you keep your Doberman on heartworm preventative? Have you checked the available dogs on our website? What is your timeframe for adopting? If so, which dog are you interested in? Revision H (8/22/2015) Adoption Page 1 of 5

2 Preferences Sex: Male Female No Preference Ears: Natural Cropped No Preference : Puppy Juvenile Young Adult Adult No Preference Color: Black/Tan Red Fawn Blue Albino No Preference Tail: Natural Docked No Preference Current Pets (list each pet individually) Firsts Pet: Type of Pet Second Pet: Type of Pet Third Pet: Type of Pet Are all pet s rabies and other vaccinations current? Tell us anything about your other pets you want us to know: Are dog(s) on heartworm preventative? Revision H (8/22/2015) Adoption Page 2 of 5

3 Prior Pets (list each pet individually) Type of Pet #1 Type of Pet #2 Type of Pet #3 Type of Pet #4 If any of the above were given away, returned to a breeder or taken to a pound, shelter, or rescue please explain the reason. References (Provide the name, relationship, , and/or telephone number of two references. (At least one reference should not be related to you.) Reference #1 Reference #2 Reference #3 Vet Vet Address Vet Address Vet City Vet State Vet Zip Vet Phone Vet Fax Revision H (8/22/2015) Adoption Page 3 of 5

4 Have you applied to adopt from other rescue groups (any breed)? Please List: About the Dog I want this new animal as: Check all that apply. Family Pet Pet for my children Companion for myself Companion for other pet Security Gift Other If a gift, do they know you are getting this pet for them? to recipient? Where will the pet be kept during the day? How many hours a day will it be alone? Where will the pet be kept at night? How will the pet be kept confined to your property? Check all that apply: Fenced yard On a leash Kennel Chain Garage Patio Inside only Other Where will the dog stay when you are out of town? Check all of the following that may cause you to have to give up the animal: Birth of a child New roommate Marriage Divorce Unemployment Pet becomes ill requiring regular medication Allergies Other What will you with the pet if this occurs? What will you do with the animal if you move? Methods you plan to use to discourage unwanted behavior(s). What kind of personality traits are you NOT willing to live with? Check all that apply. Excessive barking Unfriendly toward other pets Digging Jumps on people Bite Other Questions to Consider Before You Adopt Are you aware that owning a pet can be expensive and that you are responsible for medical care for the term of the dog s life? Would you be interested in volunteering with HADR? Are you aware this is a LONG TERM commitment? A Doberman s typical lifespan is 10+ years? New animals require time to adjust to their new home. What amount of time do you consider a reasonable adjustment period? Revision H (8/22/2015) Adoption Page 4 of 5

5 Signatures By signing below, I verify that all information is true and correct to the best of my knowledge. I further acknowledge that submission of this application is no guarantee of being approved for adoption. Your Signature Date Co-applicant s Signature Date Revision H (8/22/2015) Adoption Page 5 of 5