Dog Adoption Application

Hidden
Default: Adopter Status
First Name*
Last Name*
Date of Birth*
eMail Address*
eMail Address Confirm eMail Address
Street Address*
Suite | Apt or Unit Number
City*
State/Province*
ZIP*
Home Phone Number
Work Phone Number
Cell Phone Number*
- Preferred Method of Contact
- Social Media (Facebook, Instagram) Address
Employment & Schooling
- Are You Employed?*
  - Yes
  - No
- Full or Part Time?*
- Name of Employer*
- How Long Employed There?*
- Are You in School?*
  - Yes
  - No
- Full or Part Time?*
- How Did You Hear About Us?*
- What Is Your Friend's Name?*
- Which Shelter?*
- Which Rescue?*
- Please Describe*

Below are three areas for information on other members of your family. Please include all other adults, children and pets living in your home by clicking on the designated button.
Are There Other Adults In The Home?*
- Yes
- No

Add Adults

First Name	Last Name	Are They Employed?	Gender	Actions
				Edit Delete
There are no Adults.

Maximum number of adults reached.

Are There Children In The Home?*
- Yes
- No

Add Children

Name	Age	Gender	Previous Experience with Dogs:	Actions
				Edit Delete
There are no Children.

Maximum number of children reached.

Are There Other Dogs In The Home?*
- Yes
- No
Have you ever taken care of a dog before (ie dog walker, dog sitter, etc) or have any other dog experience?*
Please Describe

Add Dogs

Dog's Name	Where Did You Get The Dog?	Gender	Status	Actions
				Edit Delete
There are no Dogs.

Maximum number of dogs reached.

Are There Other Pets In The Home?*
- Yes
- No

Add Pets

Pet's Name	Animal Type	Sleeping Quarters	Actions
			Edit Delete
There are no Pets.

Maximum number of pets reached.

Would You Consider:
Fostering*
Select Gender*
Select Age Range*
Select All That Apply
Select Personality*
Select All That Apply
Select Color*
Do You Have A Preferred Dog?
Note: This does not guarantee this dog will be placed with you
List Other Dogs You Are Interested In
When Will You Be Ready To Adopt?*
Do you have any planned vacation soon?
Is There Anything Else You Would Like to Let Us Know?
I am interested in receiving pet related services and products*
- Yes
- No
Authorization
Authorization:*
I understand that I will be required to complete an adoption interview and a home visit as a part of the application process. I agree to provide a copy of government-issued photo ID and a proof of residence at my current address such as a utility bill upon approval of adoption. I understand I will need to attend a virtual or in-person orientation session for up to two hours to discuss dog's basic needs, any known medical history and behavioral issues, preventatives, and introducing a dog to resident pets/to family members.
- I agree
Authorization:*
I understand that this is a preliminary application and filing this application, going through the interview process and/or a home visit does not guarantee placement, and EveryHope Rescue reserves the right to refuse adoption to any applicant for any reason. I further understand that all information on my Preliminary Rescue Adoption Application will be kept confidential; that my application will be kept on file until I notify the EveryHope Rescue that I am no longer interested in a rescue; and that I will not be contacted unless an appropriate Dog becomes available. I give my permission for EveryHope Rescue to contact the landlord, veterinary, and/or personal references as needed. I affirm that I have answered the above questions truthfully and to the best of my knowledge. I understand and agree * *
- I agree
Email
This field is for validation purposes and should be left unchanged.

Employment & Schooling

Residence

Yard Information

Family & History

Feeding & Exercise

Sleep & Alone Time

Behavior & Training

What Behaviors Can You Tolerate (and work on)?

Personal Reference

Please Provide A Personal Reference

Veterinarian Information

Would You Consider:

Authorization

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Dog Adoption Application

Employment & Schooling

Residence

Yard Information

Family & History

Feeding & Exercise

Sleep & Alone Time

Behavior & Training

What Behaviors Can You Tolerate (and work on)?

Personal Reference

Please Provide A Personal Reference

Veterinarian Information

Would You Consider:

Authorization

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