Heartland Humane Society Adoption Application
Thank you for you interest in adopting from Heartland Humane Society. We are committed to connecting great pets with great people and enriching the lives of our animal friends by placing homeless pets in permanent homes. It is our responsibility to find the best homes for them, which is why we reserve the right to approve or deny any adoption. Please complete this application as fully as possible, and give us 24 hours for a response.
I am interested in adopting a: *
Required
Specific Animal or Breed you are wanting:
Your answer
Name(s) of Adult(s) living in home: *
Please list first and last names.
Your answer
Home Address: *
Please list street address, city, state & zip code.
Your answer
Phone Number: *
Your answer
Email Address:
Your answer
Place(s) of Employment and job title(s): *
Your answer
Your place of residence: *
What is your current residence? *
If you rent or live in a condo, does your landlord/association allow pets?
PLEASE COMPLETE IF YOU RENT.
Name and Number of landlord/Condo Association:
PLEASE COMPLETE IF YOU RENT.
Your answer
Do you have any plans to move within the next few years? *
If you had to move, what would you do with your pet? *
Your answer
Do you have children in the home? *
IF YOU HAVE CHILDREN IN HOME OR THAT VISIT, what are their ages?
Your answer
Are all members of your household in agreement about adopting a pet? *
Reasons for adopting: *
Please mark all that apply.
Required
Who will be primary caregiver for this pet? *
Your answer
Who will be financially responsible for this pet? *
Your answer
In the case of emergency or if you are gone on a trip, who will care for your pet and what arrangements would you make? *
Your answer
How many hours will pet need to be alone on a typical day? *
Do you have any current pets? *
IF YOU OWN PETS, PLEASE LIST THEM BELOW IN DETAIL:
List as follows: Animal Name, Breed, Age, Gender, and how long you've had.
Your answer
Are all your animals spayed or neutered?
Have you owned any pets in the past? If so, please list Animal Name and type. *
Your answer
Who have you vetted your animals with in the past?
Please list Veterinarian name and phone number, we will call them for a reference.
Your answer
Have you ever adopted from a shelter or rescue facility? *
Have you ever given a pet away, given pet to a shelter or rescue group, returned a pet or sold a pet? *
If you have rehomed a pet, please explain:
Your answer
Where will your pet live? *
Where will your pet be when no one is home? *
Required
Do you have a fenced in yard? *
Are you committed to providing a home for the life of the pet (possibly 10-20 years in some instances)? *
If your pet developed behavioral issues, how would you handle them? *
Behavioral issues can include eliminating outside the litterbox, spraying, biting, aggression, scratching, not getting along with other pets, barking, destruction, howling, mounting, rough play, separation anxiety, whining, etc. PLEASE MARK ALL THAT APPLY.
Required
What bad pet habits can you not tolerate? *
Please be as detailed as possible. What is a behavior you absolutely do not want to add to your home.
Your answer
On a scale of 1-10, how likely are you to participate in obedience or behavioral training with your adopted pet? *
This includes obedience classes or pet behaviorists.
Not at all likely
Absolutely!
What energy level do you prefer? *
Please be as honest with this question as possible. Often mismatches are made because of energy level differences. What type of energy level do you want to spend the next 10-20 years with?
How do you plan on exercising your pet? *
It is very important that a pet gets the exercise they need, how do you plan to accommodate these needs?
Your answer
How do you plan on disciplining and/or training your pet, what has worked in the past? *
Your answer
Are there any other questions you have for us?
Your answer
How did you hear about us? *
Please select all that apply.
Required
Please read the following and type your name to confirm that you understand and agree: *
HHS requires an adoption fee (see list below) for this animal to help defray our expenses for food and veterinary care provided. HHS has a very limited budget. If the animal is not already spayed or neutered and hasn’t received their first-year vaccinations/care, there is an additional $150.00 deposit for canines, and a $125.00 deposit for felines required. This deposit will be refunded to you once the spay/neuter and first year puppy or kitten care has been completed and proof has been provided. Animals currently in your care or living in your residence must be up-to-date on vaccinations. Proof of vaccinations may be required prior to adoption. I certify that the information provided on this application is accurate. I understand that giving false information or withholding information on this application can be considered a violation of the adoption agreement and result in the HHS reclaiming this pet. By choosing to adopt, I understand that I am expected to make a considerate commitment of time and money to this animal for his/her lifetime – up to 20 years in some cases. ALL PETS LEAVING HHS CARE MUST BE TAKEN IN A CARRIER OR BY LEASH/COLLAR. IF YOU DON'T HAVE EITHER WITH YOU AT TIME OF ADOPTION, YOU WILL BE REQUIRED TO PAY $5 FOR A TEMPORARY CARRIER OR LEASH/COLLAR COMBO.
Your answer
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