CanineApplication/Adoption Dog wanting to adopt: ______

Revised: March 2010

To be considered for adoption of a dog you need to:

Be at least 18 years old.

Have the knowledge and consent of all adults living in your household.

Have a valid government-issued photo ID.

Have landlord’s consent to bring an animal onto the property.

Understand that you are making a lifetime commitment to the dog. Remember that the animal you choose has already been abandoned or unwanted at least once in its lifetime. Dogs may live 12-15 years or more. Your thoughtful consideration and commitment will help insure a lifelong placement.

Understand that Honey Do Animal Rescue reserves the right to refuse the adoption of any animal.

Provide the name and contact information of 1 or more references [attach].

Applicant Information

Name [first, middle, last]: ______

Mailing Address: ______

City, State & Zip: ______County: ______

Home Telephone: ______Work Telephone ______

Cell Phone: ______E-mail Address: ______

Do you □ Own or □ Rent your House, Apartment, Mobile Home, or Condo? If you rent,

Landlord’s Name/Management Company ______Phone: ______

Why do you want to adopt this pet? ______

How many pets do you currently have in your household?

Cats: ____Breed(s): ______Spayed/neutered? □ Yes □No Ages:______

Dogs: ____Breed(s): ______Spayed/neutered? □ Yes □No Ages:______

Other: ____Types: ______Ages: ______

Are there children living in the household? □Yes □ No Ages: ______

Does anyone in the household have animal allergies? □Yes □No If yes, how do you plan to manage this issue? ______

Will this pet be kept indoors or outdoors? □ Indoors □Outdoors □Both If the pet will be outdoors what shelter is be provided? ______

How will you keep this pet confined to your property when it is outside?

□Kennel □Fenced Yard □Invisible Fence □On a Leash □A Tie Out

Are you familiar with the animal laws in your town? □No □Yes

Can you afford veterinary care, grooming, emergency expenses, supplies and food for the lifetime of this pet? □Yes □No If you have a veterinarian, please provide contact information:

All pets making the transition from shelter to a new home need time to adjust to a new family and may requirehousetraining and behavior training. Are you willing to provide any needed training? □Yes □No

Information regarding the history, health and behavior of adopted animals may not be available or accurate.

  • What behavior would you be unwilling to work with?______
  • What reasons might cause you to return this pet?______

Because rescue animals have unknown medical histories, a quarantine period is recommended if you haveother pets at home.

By signing below, I certify that the information I have given is accurate and complete. I hereby grant Honey Do Animal Rescue permission to confirm any information provided in this application/adoption agreement with any appropriate third party including landlords and veterinarians. I agree to pay HDAR the adoption fee of $ ______. I understand that if I can no longer care for the dog that I may return the dog to HDAR but that no portion of the adoption fee will be returned. I understand that once the adoption is finalized 1) I will be responsible for all medical bills and decisions regarding the dog and 2) I agree that neither Honey Do Animal Rescue nor its Board Officers/Members, volunteers, or agents will be liable for any damages or injuries caused to me or any third person by the dog.

Applicant/Adopter Signature: ______Date: ______

□ Approved By: ______Date: ______

□ Disapproved By: ______Date: ______

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1 Applicant/Adopter Initials: ______