HARVEST HILLS ANIMAL SHELTER, INC.
ADOPTION APPLICATION
The following questions are designed to help you thoroughly understand
the responsibilities of the lifetime commitment you are about to make.
Please answer all questions honestly. This application will be reviewed
by a staff member to make sure that this adoption is in the best interest
of both the animal and you. Harvest Hills Animal Shelter, Inc. reserves
the right to refuse any adoption which it determines will not be in the
animal’s best interest. Thank you for considering adopting a pet from HHAS.
Please be aware that most of the animals that are here will need much
patience, understanding, time, and training to make them the friend you
want them to be. The period of adjustment will be different for every animal.
We cannot guarantee the health or temperament of any animal.
A cat/dog may live
up to 20 years. Are you committed to providing care for an animal for that
length of time?___________
Responsible pet owners see that their pets get yearly booster shots, are
kept free of intestinal parasites, and protected from heartworm. Pet care
is expensive: Cats $200-$400 per year and Dogs $300-$600 per year. Can
you make this financial commitment to a pet?______________
An animal needs more than food and water. An animal friend needs to be
made part of the family unit. Tying a dog in the back yard and leaving
it there does not provide the love and attention the animal needs. Will
you provide the love and attention this animal deserves for its lifetime?______________
In the case of puppies and kittens: are you prepared to accept the responsibility
for looking after and training a young pet?_____________
Cute, cuddly puppies and kittens grow into adult dogs and cats, sometimes
with few of the characteristics with which they began life. Will you provide
the animal a good home regardless?_______________
Since many shelter animals have unknown behavior, are you prepared to spend the necessary time to train or re-train your pet?___________
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IF YOU CAN ANSWER YES TO THE ABOVE QUESTIONS, PLEASE CONTINUE AND ANDSWER THE QUESTIONS FOLLOWING:
Name:_________________________ Physical Address:________________________
Town:_____________________ ____State:_________ Zip:________________
Mailing Address:__________________________________________________
Town:_________________________ State:_________ Zip:________________
Home Telephone:_____________________ Cell Phone:___________________
Place of Employment:_______________________Work Telephone:_______________
How long have you lived at this address? ___________ Do you: Own Rent
Landlord’s Name and Telephone:_______________________________________________
Driver’s License Number:_______________________ Date of Birth: _________________
How many in household? _______________ Ages of all: ____________________________
Does anyone in your home have allergies? _____________ What Kind? _______________
Do all the adults in your home know that you plan to adopt a pet? __________________
Do you have pets now? _________ How Many? _________
Please list the type, sex, name, age, and if they are spayed or neutered:
__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Have you owned pets in the past? _________ If yes, please answer below:
Type: dog/cat (circle one) Type: dog/cat (circle one)
Breed:_______________________ Breed:________________________
Sex: _________________________ Sex: __________________________
Spayed/neutered? _____________ Spayed/neutered?_______________
Age:___ Dates Owned:_________ Age:___ Dates Owned:______ _____
Where is he/she now?__________ Where is he/she now?____________
Lines for Additional Pets:_________________________________________________
______________________________________________________________________________________________________________________________________________________
___________________________________________________________________________
Your veterinarian is: _________________________________________________________
City:___________________ State:______________ Telephone:______________________
How many hours will your pet be left alone during the day? _______________
Where will your pet spend the day? ___________________________________
Where will your pet spend the night?__________________________________
How will your pet be exercised?______________________________________
How will your pet be confined to your property?_________________________
What type of shade/shelter will your pet have outdoors?___________________
Who will care for your pet when you are away?__________________________
Are you planning to move in the next year?__________
If yes, what do you plan
to do with your pet/pets?__________________________
HHAS would like to
point out how difficult it is to find housing that accepts pets and wants
everyone to be very aware of this problem and just how difficult it can
be.
Have you ever had a problem with your neighbor and pets?____________________
When your pet is left alone, how will it be confined/amused to prevent or control destructive or bothersome behavior due to boredom?__________________________________________
____________________________________________________________________________
Will your cat be allowed outside?_________________________________________________
What are your reasons for adopting a pet? (circle as many as apply)
Companion Children Gift Guard Hunting Other:_______________________
Are you familiar with local animal services, licensing, and leash laws?________________
Have you ever adopted from an animal shelter before?_____________________________
If yes, which one?__________________________________________________________
Have you ever surrendered or brought in a stray to an animal shelter before?_________
Please List two non-family references, including name and phone number:
1.__________________________________________________________________________
2.__________________________________________________________________________
I, the undersigned, have read and truthfully answered the questions on these pages. I understand that HHAS, Inc. has full authority to approve or deny my application. I realize that any false information could result in forfeiture of the animal.
Signed:____________________________________Date:_________________________
Print Name:______________________________________________________________
HHAS Use Only:
Approved/Disapproved_____ Staff Initials:______ Checked: Vet____ Landlord________
References______ Comments__________________________________________________
____________________________________________________________________________
Animal ID# ________________