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Application
PET INFORMATION
Pet Information
*
Which pet are you interested in adopting? (Please include name, gender and brief description of the cat/dog.)
Type of Pet
*
Cat
Dog
Date
*
Name
*
First
Last
Occupation
*
Spouse/Partner's Name
First
Last
Address
*
Street Address
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Home Phone
*
Daytime Phone
*
Email
*
RESIDENCE INFORMATION
1. What type of residence do you live in?
*
Apartmant
House
Condo
Townhouse
Other
2. Do you rent or own the place in which you reside?
*
3. If you rent, does your landlord allow pets on the premises? (Please provide landlord’s name and phone number.)
4. How many people reside in your household?
*
5. Is anyone in your household allergic to cats/dogs? Please specify.
*
6. Are there any children in your household? If yes, please provide number and ages of all children.
*
7. Have your children been around pets before? If yes, please specify type of pet and circumstance.
8. Are there any other pets currently living in your household? (Please specify type and age.)
*
PLEASE ANSWER THE FOLLOWING QUESTIONS IF YOU ARE INTERESTED IN ADOPTING A CAT
1. The adopted cat would be: (Please check one)
*
Indoor Only
Mostly Indoor
Mostly Outdoor
Outdoor Only
Other
2. The adopted cat would have access to: (Please check all that apply)
*
Backyard
Frontyard
Patio
Balcony
None of the above
3. Do yu have a cat door?
*
Yes
No
4. Where would the cat’s litter box be located?
*
5. Have you owned a cat before? If yes, what happened to it?
*
6. Was your previous cat declawed?
*
7. Would you like to declaw this cat?
*
PLEASE ANSWER THE FOLLOWING QUESTIONS IF YOU ARE INTERESTED IN ADOPTING A DOG
1. The adopted dog would be: (Please check one)
*
Indoor Only
Mostly Indoor
Mostly Outdoor
Outdoor Only
Other
2. The adopted dog would have access to: (Please check all that apply)
*
Backyard
Frontyard
Patio
Balcony
None of the above
3. Do you have a dog door?
*
Yes
No
4. Where would the dog be allowed to go to the bathroom?
*
5. How often would you take your dog out on walks?
*
6. How often would you take your dog to the dog park?
*
7. If your dog showed behavorial problems, what would you do?
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8. Have you owned a dog before? If yes, what happened to it?
*
OTHER
1. Where would your pet sleep at night?
*
2. What type of food will you feed your pet? (Please check all that apply)
*
Dry Food
Wet Food
Human Food
Other
3. What will happen to your pet when you go out of town?
*
4. What would you do if you had to move and had difficulty finding a place that allowed pets?
*
5. What would happen to your pet if you had to move out of state or out of the country?
*
6. What would you do if your pet got sick or injured?
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Try home remedies
Take it to the vet
Wait for the illness to pass
Other
7. Can you afford regular veterinary care for this pet in order to maintain its health?
*
8. Can you afford higher veterinary costs in case of serious illness or injury?
*
9. Do you have a veterinarian? If yes, please provide veterinarians name and phone.
*
10. For what reason would you give up your pet?
*
Moving
Illness
Divorce/Separation
Allergy
New baby
Scratching members of the household
Damaging Furniture
Peeing on carpet/walls/furniture/etc.
Problem getting along with otherpets
New household member doesn't like pet
None
Other
11. If for some reason you had to give up your pet, what would you do?
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Find a good home for it
Let it out so that it could find a home for itself
Take it to the shelter
Seek assistance from There is Hope
Other
12. Would you be open to allowing There is Hope to conduct a home inspection prior to finalizing adoption?
*
13. Would you mind if There is Hope occasionally contacts you to check on your new pet?
*
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