Helping Animals Rescue Team
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Helping Animals Rescue Team Adoption Application

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 *

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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 
 No 
 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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