Helping Our Pets Endure
Dog Adoption Application
Please DO NOT hit the Enter key until the form is complete. Tab through each of the fields.
Date:
Name of Dog You Are Interested in Adopting:
Your Name:
Your Address:
City: State: Zip Code:
Home Phone: Cell Phone:
eMail: Age:
Employer: Occupation:
Please Tell Us Why You Would Like to Adopt This Dog:
How Many People Are in Your Household?
What Are the Ages of Any Minor Children in Your Household?
How Many Hours Will the Dog Be Left Alone?
When Alone, Where Will the Dog be Kept?
Have You Owned a Pet Before? Yes No If No, Can You Tell Us Why You No Longer Have the Pet?
Do You Understand Due to the Change in Environment, There May Be Accidents Until the Dog Settles In? Yes No
Do You Currently Have a Veterinarian? Yes No
If Yes, Please Provide Us With Your Current Vet's Name, Address and Phone Number:
If No, What Veterinarian Do You Plan on Taking Your Dog To?
Do You Currently Have Other Pets? Yes If Yes, Please List:
Are Your Current Pets Spayed/Neutered? Yes No
Do You Currently Own or Rent Your Home? Own Rent
If Rent, Please Provide Us With Your Landlord's Name and Phone Number:
Where Will Your Dog Be Kept During the Day?
Do You Have a Fenced in Yard? If so, what type of fence do you have?
How Do You Plan on Exercising Your Dog?
Under What Circumstances Would You Give Up Your Dog? (Please be specific, biting, chewing,
moving, too much vet care, etc.)
Do You Understand if For Some Reason You Are No Longer Able to Keep Your Dog, You Must Return the Dog to HOPE for Pets?
Where Will Your Dog Stay While You Are On Vacation?
Is There Anything Else You Would Like to Tell Us?
Please Provide Us the Name, Address and Phone Number of Two References, Not Related To You:
Do You Understand There is a $100.00 Adoption Fee Non-Refundable After Thirty (30) Days? Yes No
I have read the above information carefully and have filled out this application honestly. I understand that
omission of information and/or failure to answer all questions and sign the application can result in this
application being declined. Also, if an omission or untruth is discovered after an adoption takes place, I
understand and accept that HOPE for Pets has the right to annul the adoption and reclaim the pet.
I give HOPE for Pets permission to fully investigate the information provided as well as contact veterinarians and
related officials. If the application passes this review, I agree to a home and yard visit on a mutually agreed date
by a HOPE for Pets representative before an adoption decision is made.
Furthermore, I understand and accept that the adoption decision depends upon many factors, including, but not
limited to, the compatibility of the family and home to the individual pet and other applications received on the
pet. I understand and accept that it is HOPE for Pets’ prerogative to decide which home is most appropriate for
the individual pet, and therefore I will not take issue with the decision. Unless otherwise indicated by HOPE for
Pets, I may be considered for another pet.
Applicant’s Signature: Date:
Co-Applicant’s Signature: Date:
