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Homeward Bound Humane Society - serving Anson County

Adoption Application

click here for Foster Application 
Please fill out all the information below, at the bottom click Submit (once only please), and it will be emailed to us. We will print it out and fill in, date and sign the rest when you come in to adopt your new pet.

This questionnaire is intended to be a guide to help you think about all the ways a rescued pet will impact your life and also to determine if you are a suitable match for one of our rescued pets. All of the questions concern various aspects of pet ownership that should be given serious consideration before deciding to share your life with any animal. The information you provide on this application will help us to find the most suitable pet for your family. Please complete every question.

Incomplete applications will not be considered.

Personal Information:

First & Last Name:
Address:
City: State: Zip:
Email Address:
Daytime Phone Number:
Evening Phone Number:
Drivers License:
Licensed In State Of:
Your Age:
Employer:
Spouse/Significant Other:
Spouse/Significant Others Age:
Spouse/Significant Others Employer:

Family Information:


Children living at home:
How Many:
Age:   Age:   Age:   Age:   Age:
Does anyone else live in your home? Yes No
Does anyone in your home have allergies or asthma: Yes No

Your Residence:

Which of the following best describes your living situation:
House Condo Mobile Home Apartment Other
Do you: Own Rent Live with Parents
If you rent, Please provide your landlord's name, address and phone number (this must be complete and we will verify):

Renters must provide landlord statement indicating that a pet may live on the premises.
How long have you lived at this address?
If less than 2 years, previous address and landlord:

Do you have a fenced yard? Yes No
Please Describe:
If you don't have a fenced yard, are you prepared to leash walk? Yes No
What will happen to your pet if you must move unexpectedly?

Where will you keep your pet if you go on vacation or in the case of an emergency?

Care and Responsibility

Is there a particular pet you are interested in? Yes No
Name of Pet:
On a typical day in your home, a pet will be alone? More than 10 hours 8-10 hours 4-7 hours Less than 4 hours Never, someone is always home
Your home is usually: Busy-people coming and going all the time Moderate-some activities and visitors Quiet and calm
What do you expect your monthly expenses to be for your new pet $25 or less $50 to $100 $100 to $200 Over $200
Who will be the primary caretaker for your new pet:
Where will the pet be kept? Inside Outside Other (specify):
Where will the pet sleep at night?
If necessary, would you be comfortable doing some training or attending obedience classes with your pet to correct behavioral issues or improve manners? Yes No (explain)
Under what circumstances might you want to return your pet? (Examples: Marriage, new baby, divorce, behavior issues, financial stress, moving, job change, etc.)
How long will you give your new pet to adjust to its new surroundings?

Answer the following if you are interested in a DOG

Would you prefer a dog that is: Very active-run/hike/bike or do other outdoor activities with you
Moderately active-some hiking or daily moderate walks Less active-some walks Couch Potato-spend most time indoors relaxing with you
Would you prefer male or female dog? Male Female

Answer the following if you are interested in a CAT

Would you prefer a cat that is: Mellow and relaxed Active and playful A good mouser
Would you prefer male or female cat? Male Female

History of Pet Ownership:

Do you currently have other pets? Yes No
If yes, please describe each pet in detail (species, age, breed, sex, spayed/neutered, personality):
If you have pets that are not spayed or neutered, please explain why:
Have you ever taken a pet to a shelter, sold a pet, or found a new home for one? Yes No
If yes, please explain why:

Your Veterinarians Information:

Veterinarian Name and Telephone Number:
Animals seen at that vet clinic:
Are your pets current on vaccinations? Yes No
If you own dogs are they on heartworm preventive medication? Yes No
Please list all the animals you have owned in the past 5 years and what happened to them:

References:

Please list the names and telephone numbers of 2 references not related to you.
Name: Phone Number:
Name: Phone Number:
Any Additional Comments?
How did you learn about HOBO?

By signing below, Applicant certifies that the above information is true and understands that, prior to being approved for adoption, this information will be verified. Applicant certifies that he/she is financially and physically able to care for the animal. The adopted Pet will be spayed/neutered, current on vaccinations and on heart worm preventive medication if applicable, prior to placement. Approved adoptions require a signed Adoption Contract and an adoption donation to HOBO upon taking possession of the Pet. This is printed right on our copy of the application and by signing and sending this (electronically) you agree that you UNDERSTAND and FULLY AGREE to the terms of this document.

HOBO reserves the right to decline any application.

Signature:

After you click submit you will be taken to a copy of the adoption application, print it out and save to bring with you.

 
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