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Adoption Application

COMPANION ANIMAL ADOPTION QUESTIONNAIRE
* = required
*Name of animal(s) you're interested in
How did you hear about us?
 Store  Craigslist  Website
  Word of Mouth  Virtual Pet Adoptions  Advertising
 Pet Finder  Video advertising  Other
Tell us about you!
*Name
*Address
*City: State:
*Zip:
*Day Phone: Evening Phone:
*Email:
 
How many people in Home?
Children? Yes No  Ages
Where do you live?
Own or rent? Own Rent  If you rent, do you have landlord approval to have pets?
Yes No 
 
I wish to adopt a  Cats Dogs
Do you have other pets? Yes No  If so, what kind?
 
What kind of dog are you looking for?
Size (when grown)
Hair Length
Sex
Age Preference
Any Specific Breed/Type/Mix?
1. Are all adult members of your household in favor of adopting this animal?

Yes No 

2. Is anyone in your household allergic to animals of any kind?

Yes No 

3. Why are you looking for a companion animal? Choose as many as apply.

 Security  Companion
 Company for other pet  Gift
 Other
4. Will someone be home during the day?
Yes No 
5. What is the maximum amount of time that the animal would be left alone each day?
6. Where will the animal be during the day? Please describe.
7. Where will the animal sleep? Please describe.
8.

Do you have a fully fenced yard?

 

Yes No  If yes, height of fence?
9. Are you aware that dogs and cats should always wear id tags, and that dogs must be currently licensed and wear that license at all time?
Yes No 
10. Are you aware that, after the initial investment,the average cost of feeding and caring for a pet can be $1,000 per year (or more) for dogs and $500 per year(or more) for cats?
Yes No 
11. Are you prepared to make a committment to this animal's liftime that could last between 10 to 20 years?
Yes No 
I certify that the above information is true and correct to the best of my knowledge. I further agree that any doption made on the basis of this questionnaire is null and void if any of these statements are untrue. I understand that Hopalong & Second Chance Animal Rescue's main concern is that all pets be properly cared for by their owners. I understand a minimum adoption donation of $95 for cats, $200 for dogs (over 6 months of age), and $250 for puppies (dogs 6 months of age and younger) is necessary to offset the costs incurred related to rescue, care and adoption.I understand that Hopalong/Second Chance Animal Rescue reserves the right to deny adoption of any animal.
 
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