Adoption Application

Helping Animals Rescue Team Adoption Application
Being a caretaker to an animal is a big responsibility. Therefore, HART wants to ensure the adoptable pets in our care are provided the emotional and physical care necessary for the length of the pet's life. To ensure that the animals we are trying to adopt are given the beset possible homes, we ask that you complete this application and expect to spend time discussing the completed application with one of our adoption counselors. It should be made clear that HART reserves the right to deny the adoption of any animal, for any reason, and all applicants must be at least 21 years of age. Completion and submission of this application in no way guarantees receipt of animal applied for. A separate adoption agreement/contract will be signed at the time of adoption.

Name *

Name and/or description of animal you are interested in adopting *

Address *

Street Address
Address Line 2
City	State / Province / Region
Postal / Zip Code	Country

Phone *

###

####

Email

Do you... *

Own your home

rent a house/apartment

If you rent, provide your landlord's name and telephone number.

How many adults in your household? *

How many children in your household? Please provide ages also. (If none please enter "none" *

Please describe all animals currently in household. *

Are all current pets currently spayed or neutered? *

Yes

Not applicable

Please describe all pets owned in the last 5 years that you no longer have. Include the reason why you no longer have them. *

Who Will be the primary caretaker for the animal? *

Veterinarian name and phone number: *

Describe where the animal will be kept during the day *

If outside, please describe shelter and any fencing

Provide 2 (TWO) personal references not related to you and include contact information *

Describe your reason for wanting to adopt a pet *

Describe any circumstances under which you would get rid of the pet you are interested in adopting *

Describe what you feel is appropriate discipline for your pet *

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