2017 HAA Adoption Application
Adoption Application 2017
Which dog/puppy are you considering for adoption? If you are not sure yet, please put still looking. Also, if their are multiple ones you are considering, please list all. *
Your answer
Your Name: *
Your answer
Phone: home & cell with area code *
Your answer
FULL Address with City, State and Zip *
Your answer
Email Address: *
Your answer
Employer/Employment Status: *
Your answer
Please list the ages of all persons living in your home. *
Your answer
Does anyone in your family have allergies? What will you do if a family member is allergic to this dog? *
Your answer
Where will the dog be when the owner is home? *
Your answer
Where will the dog be while home alone? *
Your answer
Where will the dog be at night? *
Your answer
How will the dog be cared for if the owner is vacationing or for any reason has to be away? *
Your answer
Do you have a fenced yard? (this is not necessarily a requirement) *
If no, how do you plan to let the dog out? How do you plan to keep the dog safe from traffic or running away? How close do you live to a street or road? *
Your answer
*Note - " Tennessee has a state law (§ 44-8-408) that makes it a crime to allow a dog to run at large. The dog must be under control at all times if out. "
Do you rent? If yes, landlord's name, address and phone #. Does your lease allow pets? Is there a deposit required? *
Your answer
What pets are currently living in your home? Are they inside or or outside pets? If no pets currently, have you ever owned any pets? *
Your answer
Name of your veterinarian? Vet address and phone # *
Your answer
*** If a puppy ... When do you plan to have your dog spayed or neutered? *
Your answer
Have you ever adopted a pet? If yes, when and where? *
Your answer
Do you agree to have a shelter representative visit your home prior to adoption? *
Please list two personal references and their contact information. These should be persons that can verify that your home is a safe and dog friendly environment. *
Your answer
How did you hear about us? *
Your answer
By submitting this application I certify that the information I have given is true and that I recognize any misrepresentation of the facts may result in my losing privilege of adoption. I authorize investigation of all statements on this application. I further understand that I have read and signed the adoption agreement and that I have read and understand all documents making up this adoption packet. I understand that if I feel I cannot keep the dog for any reason I MUST return him/her to the animal shelter, and must not sell/give him/her to anyone else.
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms