Dog Adoption Application

The Homeward Animal Shelter strives to place the animals entrusted to our care in permanent, loving homes. The purpose of this application is to aid us in that process and to get acquainted with prospective adopters. We want to help you in your choice of a dog that will be well suited to your family, home, and lifestyle. Your decision is important since this is a lifetime commitment.

Your Contact Information
Dog Information

Name of Dog(s) you are interested in adopting

Who are you adopting this pet for?

Reason that you want a dog (check as many that apply)

If you move in the future, what will you do with the dog you adopt?

During the day, where will this dog be kept? (Check all that apply)
During the night, where will this dog be kept? (Check all that apply)

This pet will be without human companionship for how many hours per day and how many days per week?

Do you plan to take your dog to obedience training?
About You & Your Household
Please indicate the type of you home live in?

If you rent, Landlords/Rental Agencies will be contacted to verify permission to own pets. This includes mobile home parks. Please provide the following:

Do you have a fenced yard?

How many people live in your household?

If there are any children under the age of 18 in the household, please list their ages here:

Are all household members in agreement with this adoption?
Do you run a daycare in your home?
Do any household members have pet-related allergies, and if so, to what?
Have you ever owned a dog?
Have you discussed the energy level of this dog with a staff member?
Have you ever adopted a pet from this or any other shelter/rescue?
Have you ever given a pet away or surrendered a pet to a shelter/rescue organization?
Are you aware of the time, financial cost, and commitment involved in owning this dog?
Are you a student?
Current & Previous Pets

Please list all animals in your care in the last 5 years (include roommate's or relative's pets currently residing in your home).

Please list the following for each pet: Name of Animal; Species (dog,cat,other); Breed; Age; Are they spayed/neutered? Still living with you? If not, please explain why.
Personal References

Please list two references who: 

a) Know you well 
b) Do NOT live with you 
c) Did NOT accompany you to the shelter. 

At least one reference must be unrelated to you.

Adoption Discounts
Please mark if any apply to you. We offer discounted adoption fees for senior citizens (ages 65 and over), as well as active military members and veterans. We may ask for proof of age/service.
Since many animals come from unknown backgrounds, Homeward Animal Shelter cannot be responsible for the health or behavioral problems and cannot guarantee personality or temperament. Therefore, I am prepared to provide any necessary medical care including regular vet care and annual vaccinations as well as any humane behavioral training required.

By typing my name below, I certify that the information I have given is true and that I recognize that any misrepresentation of the facts may result in my losing privilege of adopting a pet. I authorize investigation of all statements on this application.

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