Preliminary Adoption Form

Thank you for your desire to adopt a rescue animal. Please understand that filling out this application does not guarantee you will receive an animal and that placement of an animal within your home is at the complete discretion of Always Hope Animal Rescue.
Thank you for considering a rescue.

*Full Name:
Address: Apt/Suite:
City: State: Zip:
Home Phone: Cell Phone: Work Phone:
*Email Address:
*Are you 21 or older? Must be over 21 to apply and adopt.

1. Please tell us what you would consider to be the perfect pet:

What kind of personality traits are you looking for?

2. What kind of pet are you looking for?  Companion  Family pet  Child's pet
 Friend for other  Gift  Barn/Mouser

Name of the animal you would like to adopt: Gender: Male Female

3. Please list all animals you currently own:
Name: Animal: Age: Gender: Fixed: 
Name: Animal: Age: Gender: Fixed: 
Name: Animal: Age: Gender: Fixed: 
Name: Animal: Age: Gender: Fixed: 

4. Please list all the pets you have owned in the past 10 years that you no longer own:
Name: Animal: Age: What happened to it?
Name: Animal: Age: What happened to it?
Name: Animal: Age: What happened to it?

5. Current Veterinarian:
Name of Vet Clinic: Phone #:
Address: City:

6. How do you feel about the following? (Please feel free to give your opinion in detail)
Declawing (cat only):
Regular vaccinations (rabies, distemper, etc):
Outdoor cats/dogs:

7. Do you own your own home or rent?
If rent, does your landlord or lease allow pets?  Yes No

8. Years at your current address? 9. How many people in household?

10. How do you plan on keeping the animal contained outside (dog only)?  Fenced in yard  Underground fence  Tie out/Cable  Training  Other Explain:

11. Please list the ages of any children under 18 living at home:

12. Are you one of the heads of your household?  Yes No

13. Is everyone in your household in favor of adopting a pet?  Yes No

14. Who will mainly be responsible for taking care of the pet?

15. Does anyone in your household have any allergies to cats or dogs?

16. Please estimate how much time you plan to have this pet inside and outside.
Inside% of the time. Outside% of the time.

17. Where will the animal sleep?

18. What will you do with the animal while you are not at home?

19. How many hours per day would the animal be left alone?

20. How do you handle destructive behavior (i.e. scratching furniture)?

21. Have you ever raised a puppy before?

22. How would you handle a cat that is litter box trained but suddenly starts urinating outside the litter box?

23. What will you do with the animal when you go on vacation?

24. What would you do with your animal if you had to move?

25. Pets can live as long as 15-20 years. Select all of the following that may cause you to give up an animal:
 Birth of a child  New roommate  Marriage  Divorce  Biting  Spraying
 Needs regular medicine  Allergies  None

26. What kind of personality traits in a pet are you NOT willing to live with? Select all that apply.
 Excessive barking or meowing  Aggressive
 Unfriendly towards other pets  Shy, skittish or hides
 Urinates outside litter box  Jumps on kitchen counters or tables

27. Have you ever had to return a pet to a breeder or take one to a pound, shelter or rescue?  Yes No
If so, please explain:

28. Would you be opposed to allowing a volunteer from Always Hope Animal Rescue to check on and/or visit the animal at your home?  Yes No

I have read the foregoing and certify that the answers I have given are complete, true and not misleading in any way. By checking this box I am authorizing Always Hope Animal Rescue permission to contact landlords, associations and veterinarians.

I accept *Date: