Pet Adoption Application

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1About you

2About your home

3Existing pets

4Your new pet

5References & Acknowledgements

Your Name *

First

Last

Are you over 18? *

HAVA is only able to adopt animals to adults 18 and over. Please have a parent or guardian complete the adoption application!

Email *

Phone *

Mailing Address *

Address Line 1

City

State

Zip Code

Different Physical Address

My Mailing address and physical address are the same.

Physical Address *

Address Line 1

City

State

Zip Code

Household setting *

City
Suburb
Small town
Rural or farm

I live in a *

House
Townhouse
Condo
Apartment
Duplex
Other

HAVA does not usually conduct home checks, although we reserve the right to do so before adoption placement. We may also need to confirm home ownership (or landlord approval) before proceeding with finalizing adoptions.

Do you own or rent? *

Own
Rent
Other

Please explain your living situation: *

Have you obtained your landlord's approval to adopt another pet? *

Please provide your landlord's name and contact number: *

What is your home's activity level?

Busy / Noisy
Moderate Comings / Goings
Quiet with occasional guests

Please list all people living your household. (Include Name, Relationship, Gender, and Age) *

Do all members of your household agree to adopting a pet? *

Does anyone in your household have allergies to animals? *

Are you a current pet owner? *

How many? *

Tell us more! List any pets you have living or deceased. (Please include name, breed, age, altered, sex, UTD Vaccines, Heartworm, living/deceased) *

Vet Authorization

I authorize my vet to speak with a HAVA representative for a reference check.

Select your current veterinary *

Please provide your veterinary name and contact information: *

Type of Pet you're interested in *

Requested Pet Name

If you have already selected a specific pet, please provide the animal's name or intake number.
(leave blank if you have not selected a specific pet)

Do you have a gender preference of your new pet? *

Female
Male
No Preference

Ideally, how old would you like your dog to be? *

A Puppy
A year or two old is perfect for me
A mature dog suits me
I just want the perfect dog, don't care about the age

Is there a size limit you can take home? *

If my dog could fit in the palm of my hand, I'd be thrilled. (miniature)
I'd love if my pooch could snuggle perfectly in my lap. (small)
If my dog can fit in the backseat of my car, it fits perfectly with me (medium)
As they say, go big or go home! (large)

When would you like to take your companion home? *

I'm ready NOW!
I need a few weeks to get ready.
2 or 3 months is perfect
Time is not a factor if the right pet comes along

Describe the kind of dog you are looking for: *

Describe the kind of cat you are looking for: *

What traits would you like MOST in your new dog? (select all that apply)

Independence
Confidence
Protectiveness
Dependence
Playfulness
Quietness
Gentleness
Silliness
Easygoing personality
Rough housing
Seriousness
Energetic

Where will your new dog live? *

Both indoors & outdoors
Mostly indoors
Mostly outdoors
In a fenced yard
Tied up outside
Running free
Kennel/crated

Where will your new cat live? *

Both indoors & outdoors
Mostly indoors
Mostly outdoors

Where will your cat sleep at night? *

Nothing like sleeping under the stars
Curled up in bed with me
I have a cat bed for them in my house
The window is open so either inside or out

On a normal day, how many hours will your dog be left alone? *

On a normal day, when left unattended, where will your new dog be kept? *

Where will your dog sleep at night? *

Do you have a fenced in yard? *

Yes
No
Partial

Please give details on height, material, # of gates, are gates locked or lockable? *

It is difficult for us to determine if a dog is housebroken in a shelter environment. Would you be able to tolerate a few accidents? *

Yes
No
Depends

What are your plans to exercise your dog? Please list any parks near by or trails, how many walks a day, approximate length, activities such as agility. *

What plans do you have in place to provide for your pet during extended absences (deployment, business trips, vacations, etc.)? *

Have you had any experience with an emotionally or physically neglected or abused dog? *

Please provide details *

Adopting a dog is a big responsibility, and HAVA wants to make sure you understand that responsibility may include additional training, annual veterinary visits, vaccinations, annual licensing, and possible emergency care.

Are you aware of and prepared to assume the financial responsibility of your new dog? *

Adopting a cat is a big responsibility, as cats can live for up to 20 years or more! HAVA wants to make sure you understand that responsibility may include veterinary visits, vaccinations, and possibly emergency care.

Are you aware of and prepared to assume the financial responsibility of your new cat? *

Anything else you think we should know that wasn't covered above?

Please list up to three personal references that can tell us how wonderful your home would be for a pet, and a way to contact them.

How did you hear about us? We would like to know who to thank! *

Hill's Food, Shelter, Love Program

At HAVA, we are proud to be part of Hill's Food, Shelter & Love program and feed all our pets Hill's brand pet food.

We offer all adopters the opportunity to join Hill's New Pet Parent program. If you sign up, you will receive emails giving you access to exclusive pet parent resources and coupon offers. If at any time you wish to no longer receive emails from Hill's, you may unsubscribe.

Would you like to receive communications and offers from Hill's Pet Nutrition? *

Sure!
Not at this time.

Acknowledgment

I understand that HAVA is a non-profit organization whose main goal is to help bring people and pets together. I am willing to pay the adoption fee and understand that this will be applied to veterinary and rescue expenses.

By submitting this application electronically, I agree to the following:

I have completely read this questionnaire and comprehend it fully.
I certify that the above information I have given is accurate and truthful.
I authorize a HAVA member to verify any and all information in this application, including reference call checks and conducting an in-home visit inspection, to be able to approve my adoption application.

I understand that applying does not ensure approval and that untruthful answers or failure to comply with the requirements of this application can result in the forfeiture of any HAVA pet adopted by me.