Hope Animal Rescues
On-Line Adoption Application (v2016)

Adoption Fee: $225 (For all breeds, size and age)

Date: (DD/MM/YYYY) *
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Name and/or breed of the Pet you are interested in (if known):
Your answer
Driver License Number:
Your answer
Name: (First, MI, Last) *
Your answer
Present Street Address: *
Your answer
City: *
Your answer
State: *
Your answer
Zipcode: *
Your answer
How long have you lived at this address?
Your answer
Are you planning to move in the near future?
If you do move, what will you do with your pet(s)?
Your answer
Home Phone Number: (XXX-XXX-XXXX)
Your answer
Cell Phone Number: (XXX-XXX-XXXX)
Your answer
Alternate Phone Number: (XXX-XXX-XXXX)
Your answer
Personal E-mail address (not school or work): *
Your answer
Are you over 18 years of Age? *
Employer/Occupation:
Your answer
How long are you away from home each day?
Your answer
Your Current Home Environment
Adopters who do not own their own home must have their pet registered on the home or apartment lease.
Do you own or rent your home? *
Type of home you currently live in: *
Do you have a fenced yard? *
Type of Fence:
Fence Height:
Your answer
Lease/Rent
The following questions only apply if you do not own your home:
Name of the apartment complex, mobile home park or landlord:
Your answer
Are Pets Allowed?
Please list any pet restrictions (i.e., weight, number of pets allowed, etc.)
Your answer
Have you notified them of your intentions of adopting a pet?
Members living within Your Home:
How many Adults live in your home? *
Your answer
How many Children live in your home? *
Your answer
List Ages of children:
Your answer
Does any member(s) of your household have allergies?
Information of Current and Past Pets
Please list all of the pets currently residing in your home or any other pets that your dog will be interacting with (be sure to include the following: Type of pet [dog, cat, fettet, etc], Breed, Sex, Spayed/Neutered, Age of Pet: *
Your answer
Are any of these pets kept outdoors? *
Are all of these pets spayed or neutered? *
If you answered No to either of these questions, which pets are not spayed or neutered, or live outdoors and why?
Your answer
Veterinarian Information
Name of Veterinarian: *
Your answer
Veterinarian Address: *
Your answer
Veterinarian Phone Number: *
Your answer
Pet History
Have you had any pets in the past that are not listed on this application? *
If yes, list the Type of Animal, Sex, Age, Spayed/Neutered and what happened to them.
Your answer
Have you adopted any pets from a rescue group or shelter in the past? *
If yes, please list the name of the rescue(s) or shelter(s).
Your answer
Where is this pet now?
Your answer
Pet Specifics
What gender of dog are you interested in adopting? *
What age of the pet are you interested in adopting: *
What size dog are you interesting in adopting? *
How active would you like your dog to be *
I want this pet for: *
How long have you been looking for a pet?
Your answer
My pet will live: *
Will you leave your pet outside while you are gone for short periods? *
Will you leave your pet outside while you are gone for long periods? *
Will you be using a tie-out or chain to secure your dog? *
When your pet is left by itself, the pet will stay.... *
Your answer
Where will your pet sleep at night? *
Your answer
How long will your pet be left by itself each day? *
Your answer
If you do not have a fenced yard, how will you keep your pet confined to your property?
Your answer
List your personal reasons for wanting a pet: *
Your answer
Are you willing to allow a representative of our group to visit your residence? *
Use this space for any additional comments you may have:
Your answer
Contract
Please read all of the following before signing your initials in the space provided after each statement
THIS IS A BINDING CONTRACT
**Please note - Until the adoption is finalized and the adoption fee paid, the pet remains the sole property of Hope Animal Rescues. Taking a dog home on a trial does not give ownership.
1. I, the undersigned adopting party, understand and agree to the following terms and conditions of this contract in the acquisition of the above-described animal(s), hereinafter referred to as "pet" or "pets" (if adopting/adopted more than one pet *
Your answer
2. To agree to return the pet to Hope Animal Rescues if unable to keep the pet for any reason, To never abandon the pet, give to another person or surrender, sell or give the pet to a shelter, pet dealer or a laboratory. *
Your answer
3. To agree to notify Hope Animal Rescues if the pet is lost or stolen and to make all reasonable efforts to locate the pet. *
Your answer
4. To agree to notify Hope Animal Rescues in the event that the pet suffers a life threatening illness or injury, or if the pet is deceased. *
Your answer
5. To never allow this pet to be trained for or used for protection or as an attack pet. *
Your answer
6. To treat this pet as a family pet with affection and kindness, never subjecting this pet to neglect, abuse or cruelty. *
Your answer
7. To provide veterinary care for all injuries and illness, including annual shots, heart worm preventative, and parasite checks. *
Your answer
8. To always keep this pet within a fenced yard - not on a chain, or other restraint (unless being walked) or safely within the home. *
Your answer
9. To never leave the pet unattended in a yard, fenced or unfenced. *
Your answer
10. To never transport this pet unconfined in an open vehicle such as the bed of a truck or open jeep. Or in a vehicle with the window(s) down so far that the pet could fall or jump out causing injury or death. *
Your answer
11. To regularly check the tightness of any collar. To affix any licenses and tags to the collar and to never leave a choke chain on the pet when not attended. The adopter(s) shall comply with all state / local ordinances regarding pet licensing, identification, and restraint. *
Your answer
12. To notify Hope Animal Rescues of the pet's annual progress: *
Your answer
13. To notify Hope Animal Rescues if I move *
Your answer
14. To allow Hope Animal Rescues to periodically check on this pet. *
Your answer
15. To contact Hope Animal Rescues, a veterinarian, or an obedience trainer when problems arise so that the problem may be eliminated or alleviated. *
Your answer
16. That any pet over the age of 5 months and not altered prior to adoption, must be altered within 2 weeks of this signed contract. And that any pet less than 5 months of age must be altered when they reach 5 months of age. *
Your answer
17. I authorize my vet to release pet information to Hope Animal Rescues. *
Your answer
18. To forever leave the microchip in Hope Animal Rescues' Name by not having it transferred. *
Your answer
19. In the event that adopter breeches contract in such a manner that Hope Animal Rescues cannot reclaim the pet(s). Adopter will be responsible for reimbursing Hope Animal Rescues for all cost related to the care of the pet above the original adoption fee. *
Your answer
I further understand and agree that...
20. Non-compliance with any of the above terms and conditions may result in the immediate forfeiture of the pet (or multiple pets if more than one has been adopted) and that Hope Animal Rescues may reclaim pet(s) without payment of compensation to me/us. *
Your answer
21. Hope Animal Rescues has advised me/us that the pet can sometimes dig, chew, soil and exhibit other undesirable traits unless properly supervised, confined and trained. *
Your answer
22. Hope Animal Rescues has advised me/us that this pet may have been neglected, mistreated or abused and that special care or precautions may be required. *
Your answer
23. Any notices to Hope Animal Rescues required by this contract will be sent first class mail. *
Your answer
24. I/We am aware that if, for any reason, that I am unable to keep this pet, whether voluntary or involuntary, that I may not receive a full or partial refund of my adoption fee. *
Your answer
25. In consideration of the adoption of this pet, I agree to hold harmless Hope Animal Rescues and any individuals associated with Hope Animal Rescues and indemnify such organizations or individuals for any damages or costs resulting from liability, known or unknown, anticipated or unanticipated, as a result of the pet's conduct after the date of this agreement. I agree to accept responsibility for any and all future costs incurred for treatment or prevention of any illness in the pet. I understand that the pet may have been exposed to any infectious disease. *
Your answer
26. I certify the information I have provided is correct and further understand that Hope Animal Rescues may refuse to adopt to any applicant for any reason. Hope Animal Rescues is not obligated to discuss the reason for denial with applicant. I authorize Hope Animal Rescues to investigate all statement and references in this application. *
Your answer
27. By Typing my Signature and submitting this application, I acknowledge I have read, understand and agree to all terms and I understand that my Electronic Signature is the equivalent of a hand written Signature. *
Signature: *
Your answer
Date: (MM/DD/YYYY) *
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Restrictions and Process
In order to be considered for adoption, you must 1) be at least 18 years of age and 2) understand that this adoption application must be approved. Once your application is approved, you will be sent an acceptance letter via e-mail but please understand that this does not guarantee adoption. It is just the first step and the final decision will be made upon meeting you. We reserve the right to refuse an application to any applicant. Once you are pre-approved, you will be sent a phone number to call to set up an appointment to come and meed the pet. If you have a current dog(s), we encourage you to bring them with you to the meeting.
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