Pet Adoption Application

Ready to Meet Your New Best Friend?

Please complete the adoption application below as fully and honestly as possible. Your answers help us ensure the best match for both you and the pet. Once submitted, our team will review your application and contact you with next steps.

First

Last

Address

City

State

Phone

Occupation

Is everyone in the household in agreement on the decision to adopt?

Yes No

Housing Situation

House Apartment Mobile Home Other

Own or Rent

Own Rent

If you rent, please provide landlord name and contact number

Which animal are you interested in adopting?

How many adults live in the household?

How many children live in the household?

Ages of Children? (Please separate by comma)

Is anyone in your house allergic to animals?

Yes No

Does anyone in your house have any health issues?

Yes No

If yes, please describe

Do you own any other pets?

Yes No

If yes, are they fixed?

Yes No

Ages and breed of your other pets? If none, type N/A

Do any of your pets have any current health issues?

Yes No

Current Veterinarian and Contact Number

How many pets have you owned in the last five years?

What happened to your last pet?

Are you willing to allow us to do a home check?

Yes No

Please provide a reference name and phone number

Current Veterinarian and Contact Number

Do you have a fenced yard?

Yes No

Do you have a kennel run?

Yes No

If no, how will exercise/toilet be handled?

Do you live near a high traffic road?

Yes No

How many hours will dog be alone each day?

<2 2-4 4-8 >8

Use this space to add additional information on your home

Please retype your name with today's date - to serve as electronic signature

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Happy Valley Animals in Need Is a non-profit organization supported by contributions from people like you. Your donation will ensure that many animals will be rescued, receive the medical care they need, and be adopted into caring homes. We rely on donations to assist us in helping all animals in need.

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