Adopter Application

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Section 1. Applicant Information

Employer Information

Days Of Week

Sunday Monday Tuesday Wednesday Thursday Friday Saturday

Spouse/Partner Information

Other Residents in Your Home Information

Resident 1

Add another resident

How long have you lived at this residence?

Do you own or rent your home?

Does your lease/association allow pets?

Landlord:

Do you plan on moving or have the above information change within the next 12 months?

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Section 2. Preference for a dog

If there is a particular dog you are interested in, please indicate its name:

What type of dog are you interested in adopting? (Select all that apply)

Male Female

Age:

Puppy Young Adult Middle Adult Senior

What is your timeframe for adopting?

As soon as possible Within a few weeks Within a few months

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Section 3. Current Pets

Current Pet 1

Current Pet 2

Current Pet 3

Current Pet 4

Current Pet 5

Add another current pet

Do you have a current veterinarian?

If yes, may we contact him/her?

Are you current pets up to date on vaccinations and heartwworm and flea/tick preventatives?

Have any of your current pets displayed aggression toward/bitten a person or animal?

If yes, please explain:

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Section 4. Your History with pets (Skip to section 5 if not applicable)

Have you ever had to re home or put one of your animals up for adoption?

If yes, please explain:

Have any of your pets ever escaped from your yard or home??

If yes, please explain how you retrieved your pet and how you prevented him/her from escaping again:

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Section 5. At Home with Your New Dog

Where would the dog primarily live?

Inside Outside Half & Half

Where would you keep the dog during the day?

At night?

How many hours a day would the dog be alone in your home?

Where will it be kept while you are away?

Do you have a complete and secured fenced yard?

If yes, type (i.e invisible, chain link, wood panel, mesh, picket, vinyl) and height:

Is there a pool/pond on the property?

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Section 6. How You Will Train Your New Dog

Are you aware that adopted dogs can take 30 days or more to adjust to a new environment? This period will require additional vigilance on your part, an the dog may seem unenthusiastic for play or other activities.

Do you have experience training dogs?

Are you willing to attend obedience classes with the dog?

Will you agree to crate train the dog?

How will you exercise and socialize your dog, and how often?

How would you handle issues like excessive barking, marking, separation anxiety, destructiveness, etc.?

Under what circumstances, if any, would you relinquish the dog?

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Section 7. About Homes For Animal Heroes

Check the box to indicate that you read and understand the mission of Homes For Animal Heroes?

The mission of Homes for Animal Heroes is to (1) provide permanent, loving homes to retired research animals through a nationwide rehoming network, (2) educate the public about the benefits of biomedical research relating to human and animal health and well-being, (3) present an accurate representation of the care and consideration research professionals provide for the animals they work with each day, and (4) work collaboratively with the research community to promote awareness and develop a cohesive rehoming network.

I have read and understood the mission of HAH

How did you hear about Homes For Animal Heroes?

Why do you want to adopt a dog from Homes For Animal Heroes?

Provide the name and contact information of two references. (Do not list family members or roommates.)

Reference 1

Reference 2

Have you or anyone living with you ever pled no contest or been convicted of a crime involving animals?

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Section 8. Disclosures

I have read the above information carefully and have filled out this application honestly. I understand that omission of information and/or failure to answer all questions and sign the application can result in this application being declined. Also, if an omission or untruth is discovered after an adoption takes place, I understand and accept that Homes for Animal Heroes has the right to annul the adoption and reclaim the dog.
I give Homes for Animal Heroes permission to fully investigate the information provided, including but not limited to contacting my landlord, personal reference, and/or veterinarian.
I understand that a home visit may be required and agree to having a volunteer visit my home and yard to complete one.
I understand that if I support, am affiliated with, have a public agenda, or am involved with organizations that are counter to the mission of Homes for Animal Heroes, I may be declined in order to protect the best interests of Homes for Animal Heroes.
I understand and accept that the adoption decision depends upon many factors, including but not limited to, the compatibility of the family home to the individual dog, and other adoption applications received for the dog. I understand and accept that it is the prerogative of Homes for Animal Heroes to decide which home is most appropriate for the individual dog, and therefore I will not take issue with the decision.

Applicant Signature

Date

Adopters Application Form

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