Adoption Application

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Adoption Application
A successful adoption depends on both the selection of the right hound for your household and the understanding of his or her care taking needs. By completing and sending us an Adoption Application we will be able to assist you with this selection. Please answer the questions as completely as possible.

Please copy and paste the application below into an email and send it to us that way. Be sure to include the name of the hound you are interested in adopting in the subject line.

NOTE: An adoption fee of $150.00/unaltered or $200.00/altered ($75.00 for Bagel Shoppe dogs) to cover program expenses is required at the time of adoption.

Applicant First Name:	Last Name:	Age:	Occupation:
Co-Applicant First Name:	Last Name:	Age:	Occupation:
Address:	City/Town:	State:	Zip:
Email (required):	Phone:

Please list the names, addresses and phone numbers of 2 personal references:

What is the name of the hound that you are interested in?

List any general questions you would like to ask about this particular hound:

Are you willing to allow a representative from HOMEWOODS RESCUE to visit your home by appointment? Yes No

Please check any of the following reasons for adopting this hound:

Family pet	Watchdog	Hunting dog
Child's pet	Companion	Gift
Guard dog for business	Companion for other pet

If other, please specify:

Please indicate where you live:

Apartment

Condo/Townhouse

Trailer/Mobile home

House

Do you: Rent Home Own Home

If you rent, do you have the landlord's permission to own a dog? Yes No

What is the apartment complex/landlords name?

What is the landlord's phone number?

How much is the pet deposit?

How many times have you moved in the past 5 years?

If you move, will your pet go with you? Yes No

Would you ever consider moving somewhere that doesn't allow your pets? Yes No

Do you foresee any major changes in your life in the next 15 years (average lifespan of a hound) such as marriage, childbirth, health problems due to age, going away to college? Yes None
If yes, please explain:

Do you or anyone in your household currently have any serious health problems? Yes No
If so, please describe:

Can you provide a permanent home for this hound for 10-15 years? Yes No

What procedures will you use for housebreaking?

Crate training	Paper training	Rubbing nose in mess
Swatting w/newspaper	Outside only

If other, please describe:

Do you have a fully fenced yard with no fence gaps? Yes No
If yes, approximately how many square feet, how high and what kind?

If no, would you consider fencing all or part of it as a condition of adopting a dog? Yes No

Number of adults in household?
Relationship(s):

Spouse

Roommate(s)

Life partner

If other, please specify:

Does anyone in the household smoke? Yes No

Will this hound be a surprise for any family members? Yes No
If yes, who?

Do any family members have allergies? Yes YNo

Do any children live in the house? Yes No
If so, what are their gender/ages?

Please provide the number, type and age of pets currently in household.

Do any of your current or did any of your past pets live primarily outdoors? Yes No
If yes, please describe pet:

Were all previous pets spayed/neutered? Yes No

Are all current pets spayed/neutered? Yes No

If your past or present pets were not spayed or neutered, why?

Do you know what heartworm disease is and how to prevent it? Yes No

Is your current dog or was your previous dog on heartworm prevention medication? Yes No
If yes, what brand did you use and how often did you give it?

What is your veterinarian's name and phone number?

What do you expect annual pet care (vet care, medication, heartworm preventative, etc.) to cost yearly?
$

How many dogs have you owned in the past?
If any, please describe what happened to each of them (put to sleep, hit by car, died of old age, sold, given away, ran away, etc.)

Who will be responsible for the daily care and training of your new dog?

How do you plan to prevent fleas and ticks?

Are you familiar with Frontline or Advantage? Yes No

How many hours will the hound be home alone on a typical day?

Where does your current dog stay when home alone during the day?

Outside in fenced area	Outside in dog pen	In basement
In the garage	Outside on chain/tie-out	Free run of house
In one room of house	Inside in crate

If other, please describe:

Where will your new hound stay when home alone during the day?

Outside in fenced area	Outside in dog pen	In basement
In the garage	Outside on chain/tie-out	Free run of house
In one room of house	In in crate

If other, please describe:

Where do current pets sleep at night?

Where will the new hound sleep at night?

What percentage of time will the dog spend inside the house?

Will your new pet be allowed on the furniture? Yes No

Have you ever had a serious behavior problem with a previous dog? Yes No
If so, please describe:

Do you have a doggie door? Yes No
If not, and if it would work better, would you consider installing a doggie door? Yes No

Have you always kept an ID tag (other than a rabies tag) bearing your phone number on your pets? Yes No

Are you willing to keep a collar and ID tag on all of your pets including the new hound at all times? Yes No

Under what circumstances do you think it is OK to leave a dog outside alone and unsupervised in an unfenced area?

In a quiet subdivision	On a lot of acreage	___in a rural area
When I know they are trained to come back	None

If other, please specify:

What circumstances, in your mind, justify giving a dog up?

Moving	New baby	Divorce
Size	Behavioral problems	Allergies
Children lost interest	Shedding	Housebreaking problems
Medical problems	Getting out of fence	Too time consuming
Aggressive behavior	Not getting along with other pets

If other, please explain:

Have you ever given a dog up or had a dog for a brief period of time and it didn't work out? Yes No
If so, please explain the circumstances and what happened to it:

Have you ever looked at or applied for a pet with another rescue group? Yes No
If so, how long ago? Did you adopt? Please explain:

If you are unable to keep your hound for any reason at any time, will you return the hound to us? Yes No

If you date or marry someone who does not like or want your pets, what would you do?

If your pet later develops a medical problem that becomes expensive, what would you do?

Find another home for him	Pay whatever it takes
Have him put to sleep	Give him to a rescue group or shelter

If other, please explain:

If your pet develops a frequent urination problem at the age of 12 and can't hold it when left alone, what would you do?

Have him put to sleep since he is older	Baby gate him in where flooring is not carpeted
Give him to a rescue group or shelter	Put in a doggie door

If other, please explain:

If you are considering a hound, how often would the hound be groomed?
Would you do it yourself? Yes No
Have a groomer do it? Yes No

What type of food will you feed?
Something from the grocery store Premium food from a pet supply store
Brand name:

Has a dog or puppy died on your premises in the last 6 months of distemper, parvo or unknown causes? Yes No
If yes, please explain:

Do you understand that hounds are not small dogs? Yes No

Do you understand that hounds can be messy at times by dragging their ears through their food and water?
Yes, I understand, not a problem No, maybe I need more info
Does this bother you? Yes No

Do you understand that hounds drool, and will this be a problem?
Yes, I understand, not a problem No, maybe I need more info

Hounds can be very loud with their barks or howls. Would this be a problem with anyone in your household or neighborhood? Yes No

Hounds have a hound odor, some more so than others. Would the hound odor be a problem for you? Yes No

A hound's ears must be correctly cleaned, on a regular basis to reduce odor and prevent infections. Would ear cleaning be a problem for you? Yes No

Hounds shed quite frequently. Does dog hair and shedding present a problem in your household? Yes No

Are you willing to allow the hound in your home, especially in cold or inclement weather (storms, etc.)? Yes No

Scent hounds cannot be turned loose without a lead. Do you agree that if you adopt a hound that you would be willing to keep the dog in a securely fenced area of your yard, or take the dog for walks on a leash if you don't have a fenced yard? Yes No

We do not allow any of our rescue hounds to be staked, tied, or chained in any manner. Do you agree not to stake, tie or chain your hound? Yes No

If you adopt a hound, do you understand that the hound must wear a buckle collar with current rabies tag? Yes No

If you adopt a hound, do you agree to telephone HOMEWOODS RESCUE immediately if the hound should become lost or stolen? Yes No

If you adopt a hound, do you agree to notify HOMEWOODS RESCUE at least one week prior to any change of address? Yes No

If you adopt a hound, do you agree not to transfer your hound to anyone else, without prior permission from HOMEWOODS RESCUE? Yes No

If for any reason that you decide you cannot keep the hound, do you agree that the hound comes back to HOMEWOODS RESCUE? Yes No

Do you agree to home visits from HOMEWOODS RESCUE personnel, and phone calls to check on the welfare of the hound? Yes No

If you decide to adopt a hound, do you agree to a 30 day trial period with that particular hound? Yes No

HOMEWOODS RESCUE charges a fee of $150.00 (unaltered) or $200.00 (altered) for each hound adopted. The fee for Bagel Shoppe adoptions is $75.00.

If for any reason you do not want to keep the hound at the end of the 30 day trial period, do you understand that you are legally bound to bring the hound back to HOMEWOODS RESCUE, and your adoption fee will be refunded? Yes No

How did you hear about HOMEWOODS RESCUE?

Website

Newspaper

Word of mouth

Radio

At a pet adoption function

If other, please specify:

Typing or signing your name below will serve as legal signature. Applicants must be 18 years of age or older. HOMEWOODS RESCUE reserves the right to refuse any applicant.

By typing or signing below, I am attesting to the truthfulness of my answers. Falsification of any of the above information will be grounds for disallowing the adoption of the rescue hound and possible removal of said hound from my home.

Applicant Name Date