Adoption Application
The answers you provide on this application will help us determine the best possible match between you and the dogs available. Please complete the below form in detail and submit it. This is a general sequence of events in the Adoption Process. Depending upon where/how you saw the dog you are interested in the sequence of events might vary slightly. . Please allow up to a week for your application to be reviewed. Street Dog Hero will then contact you with a possible phone interview, check your references and your vet. A play date may be set for you to come out and meet the dog that you are interested in. A home check may be scheduled. Once approved complete the Adoption Contract and pay the adoption fee of $300. The dog is then placed in your care. You will receive an email containing arrival details and suggestions on how to give your new dog a smooth transition into his/her new home with you. Thank you for your interest in becoming a Street Dog Hero! You will forever be a hero to your dog.
Email address *
Applicant's Full Name *
Your answer
Address *
Your answer
City, State, Zip *
Your answer
Phone *
Your answer
When were you born? *
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Dog(s) you are interested in *
Your answer
Occupation *
Your answer
Spouse Occupation (if applicable)
Your answer
How long have you been at your present job? *
Your answer
Personal Reference #1 (not a family member) *
Your answer
Relationship *
Your answer
Years known *
Your answer
Phone *
Your answer
Email *
Your answer
Reference #2 (not a family member) *
Your answer
Relationship *
Your answer
Years known *
Your answer
Phone *
Your answer
Email *
Your answer
Type of dwelling you live in *
Do you own or rent *
Please provide landlord name AND contact info
Your answer
How long have you lived at this address? *
Your answer
Do you have a fully fenced yard that is high enough to safely contain a dog? *
How do you plan to handle exercise and potty needs? *
Your answer
Please list all human members of your household and their ages *
Your answer
Are you expecting a child or planning an addition to your family in the near future? *
Does anyone in your household have allergies to pets? *
What will you do with your pet if someone in your family develops allergies to it?
Your answer
Are all family members in agreement about adopting a dog? *
Do you own cats? *
If yes, how many?
Your answer
Do they live
Are they spayed or neutered?
Do you own chickens, livestock, farm animals, guinea pigs or similar? (if none please write "none") *
Your answer
Do you have a regular veterinarian? *
Please provide doctor, clinic name and phone
Your answer
How many dogs and cats have you owned in the last 15 years? *
Your answer
List all dogs you currently own. Age, breed, sex, altered, if they are indoor or outdoor and how long you have had them. *
Your answer
Have you ever re-homed a pet? *
If yes, please explain the situation
Your answer
Have you taken your dogs to obedience class? *
If you have a current dog, would you describe them as being alpha or submissive to other dogs? Please explain in detail: *
Your answer
What activities do you plan on participating in with your dog(s) and how often? *
Your answer
What is your household activity level? *
Please describe the area where your dog will spend the day *
Your answer
Please describe the area where your dog will spend the night *
Your answer
How many consecutive hours a day will the dog be left alone? *
Your answer
What will you do with the dog when you go on vacation? *
Your answer
What methods will you use to correct your dogs behavior that you find inappropriate? Please be detailed. *
Your answer
What do you NOT want in the dog you adopt? *
Your answer
For what reasons would you return the dog to Street Dog Hero? *
Your answer
Do you agree to license this dog in your county and provide regular health care? *
Are you willing to keep the dog for at least 3 months in order to provide time for you, your family, and the dog to adjust to the new situation? *
I understand that if I am fostering to adopt, I have 72 hours/3 days to make a final decision. If I choose to not adopt the dog, Street Dog Hero may make necessary arrangements to place the dog with another adopter or foster *
If for any reason you decide a dog placed in your home is not the right fit for your family, are you willing to foster your dog for 30 days to give Street Dog Hero the opportunity to re-home or foster it? *
Do you agree to contact Street Dog Hero if you can no longer keep this dog? *
Would you be willing to have someone visit your home by appointment for a home check or submit photos of your home? *
Acknowledgement of Responsibility
I acknowledge that this dog is a rescue, and therefore Street Dog Hero has no knowledge about the dog's ability to get along with people, children, other dogs, cats, or livestock beyond our limited experience with the animal. I also acknowledge that this rescue dog comes with no medical history other than what was observed or detected from Street Dog Hero and the original rescues who found the dog. 
 I acknowledge that the stated age of my adopted pet is determined by a city shelter veterinarian to the best of his/her ability, having no previous history of the dog. I understand that the age is not always accurate and that I should consult my own veterinarian for determination or confirmation. 
 I understand that my dog may have been exposed to illness from other dogs on the streets and may be incubating a disease. I RELEASE STREET DOG HERO FROM ALL RESPONSIBILITY regarding the health of the dog. I acknowledge that, on the day I take ownership of the adopted dog, I am solely responsible to provide and pay for veterinary care for my dog. 
 I understand I will need to follow up with my veterinarian to obtain future vaccinations for my adopted animal. I understand that in accordance with municipal and state law, I will continue to keep my pet's rabies vaccination current. I understand that when adopting a dog, especially when recently living off the streets, there are certain risks involved. I understand that Street Dog Hero, and volunteers of Street Dog Hero, provide the information they have been given on behalf of the animals being adopted in good faith and are not responsible in any way for any issues that may arise in conjunction with adoption or ownership thereafter. I UNDERSTAND STREET DOG HERO DONATION ADOPTION FEE IS NON-REFUNDABLE.
Please Acknowledge Agreement and Understanding of the above responsibilities *
Also please agree to each of the statements below indicating you accept them:
I am/we are ready to make a LIFETIME commitment to our new dog *
I/we will give our dog daily companionship and not just when it’s convenient *
I/we are willing and financially able to care for the dog *
All of the above information I have given is true and complete. If I adopt a dog from Street Dog Hero, the pet will reside in my home as a pet. I will provide him/her with adequate water, a quality dog food, shelter, training, affection and medical care. I understand that Street Dog Hero is a referral service and is not responsible for the accuracy of information received about the habits, temperament, or physical condition of the dogs available for adoption. I understand it is my responsibility to evaluate a dog for myself before agreeing to adopt him/her. I am in full agreement of the terms of the adoption. Street Dog Hero shall not be liable for, and is hereby relieved from, all liability for any damage, expenses, causes of action, fines, suits, demands, judgments, or claims of any nature whatsoever arising from or by any reason of any damage to property or injury to any persons caused in whole or in part during the visitation of the dog up for adoption AND a dog placed in your home. I hereby accept and assume such liability and agree to protect, indemnify and hold Street Dog Hero and it’s representatives harmless from and against all of the aforesaid. Completing and returning this document constitutes your permission for us to check references.
eSignature: First, Last Name *
Your answer
Today's date *
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Both parties agree that this application can be executed by the applicant and sent to Street Dog Hero via hand delivery or by Email. If the applicant would like to send the document via email, applicant and Street Dog Hero both agree that the applicant’s virtual signature is valid and binding upon the parties. Thank you for contacting Street Dog Hero. We look forward to working with you. WE RESERVE THE RIGHT, IN OUR SOLE DISCRETION, TO REFUSE ANY APPLICANT FOR ANY REASON WHATSOEVER.
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