Adoption Application Form Name of the dog you are applying for*Primary Applicant DetailsName* Mr.Mrs.MissMs.Dr.Prof.Rev. Prefix First Last Address* Street Address Address Line 2 Suburb State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Phone*Email* Employment*Employed Full-TimeEmployed Part-TimeSelf-employedNot employed but looking for workNot employed and not looking for workHomemakerRetiredStudentPrefer Not to AnswerAge*Under 1818-2122-2425-2930-3435-4445-5455-6465 or AbovePrimary Applicant must be over 21.Co-Applicant DetailsName Mr.Mrs.MissMs.Dr.Prof.Rev. Prefix First Last Email PhoneYour HouseholdHow many adults currently live in your household?*Please enter a number from 1 to 10.How many children currently live or regularly visit your household?*Please enter a number from 0 to 10.What is each persons age and exposure level to dogs?*Have the children been taught how to appropriately interact with an animal ?Is everyone in the household aware of and agreeable to your interest in adopting?*YesNoWhat type of residence do you live in?*ApartmentUnitTownhouseHouseAcreageDo you own or rent your residence?*RentOwnPlease note: If you live in a rental property you will be required to provide a letter of pet approval from your landlord. See https://www.consumer.vic.gov.au/housing/renting/applying-for-a-rental-property-or-room/pets-and-rentingDo you have the landlord's permission to keep a dog?*YesNoLandlord reference: Organization - First Name - Surname - Phone - EmailWhich council are you located in?*Do you have any future plans of moving?*If you move, what arrangements will be made for this dog if you adopt?How big is your yard?*Extra SmallSmallMediumLargeExtra LargeDo you have a pool?*YesNoIs your pool fenced and secure ?YesNoFencesHow high are your boundary fences and gates?Under 4ft4ft5ft6ft+No FencingWhat are your boundary fences constructed of?*TimberColorbondWire MeshBrickPhotos of Back fence: Drop files here or Accepted file types: jpg, gif, png, pdf.Photos of Right Side fence: Drop files here or Accepted file types: jpg, gif, png, pdf.Photos of Left Side fence: Drop files here or Accepted file types: jpg, gif, png, pdf.Photos of any Gates: Drop files here or Accepted file types: jpg, gif, png, pdf.Any other photos showing fencing: Drop files here or Accepted file types: jpg, gif, png, pdf.Breed ExperienceHave you ever owner a Siberian husky, Siberian Husky X or any Arctic Breeds?*YesNoDetails of your breed experience:Check all that apply.* I have owned a Siberian Husky or Siberian Husky X I have done research on the internet A family member owns or has owned a Siberian Husky I have talked to people who own Huskies I have read Book(s) about the breed I have a friend who owns a Siberian Husky None of the aboveAny other experience/research not listed above ?Do you have any experience training and working with dogs with behavioral issues? Please give details.Past Pet OwnershipHow many pets have you owned in the past 10 years?Dog/Cat/Other ?Briefly describe what happened to any animals you no longer have.Current Feline OwnershipHow many cat’s do you currently own?*Please enter a number from 0 to 10.Are your cat(s) inside, outside cats or both?InsideOutsideBothAre your cat(s) declawed?YesNoHas the cat(s) ever interacted with dogs?YesNoPlease describe your cat(s) interaction with dogs.Current Canine OwnershipHow many dogs do you have ?*Please enter a number from 0 to 10.Name – Sex – Age – BreedHas your dog(s) been C5 vaccinated within the last 12 months?YesNoIs your dog desexed? If not, is there a reason?*What is your dog's temperament, socialization and activity level?Adoption InformationDo you currently own any pocket pets/other animals? Please list how many and breed.*If you have listed specific dog(s) you are interested in, please tell us one thing about each dog that sparks your interestWhy have you chosen a Siberian husky?*Energy Level Preference*How much exercise will you be able to give your dog and how often?*Please tell us what specific personality traits you are looking for in your new dog.*Do you plan on letting your Husky off-lead in unfenced areas?*YesNoAre you prepared for regular grooming?*YesNoPlease tell us what you know about the Siberian Husky breed.*The New DogWhere will the dog spend the day ?*Where will the dog spend the night ?*How many hours on average will the dog spend alone?*Who will care for your dog(s) when you are on vacation?*Please let us know any other information you wish us to consider in placing a dog with you. Here is your chance to personalize this application.How did you find out about Homes For Huskies ?Home Visit and AgreementDo you agree to a representative of Homes For Huskies Rescue Inc to conduct a yard inspection of your yard, to ensure it meets the requirements of the rescue ?*YesNoWe understand that EVERYONE IN THE FAMILY, INCLUDING OTHER PETS, MUST BE PRESENT AT YARD INSPECTION AND THE POTENTIAL ADOPTION MEET & GREET. I/We further understand that completing this application does not guarantee that a dog will be placed with me. I/We understand that shall the adoption not work out for any reason he/she will not be given away, sold or put in a shelter but will be returned to Homes For Huskies Rescue Inc. I/We certify by submission of this form that I have never been convicted of any violation of any ordinance or statute enacted pursuant to cruelty, neglect or abandonment of an animal. I/We will be asked to sign an adoption agreement if a dog is placed with my family. The adoption trial is two/three weeks to ensure compatibility for both humans and dog. The adoption fee is payable before the two week trial commences. The adoption fee is fully refundable if the trial is not successful. I/We understand that owning a dog is a commitment for the dog's lifetime and if I adopt a dog from Homes For Huskies Rescue Inc. I am willing to make that commitment.I AgreeI DisagreeUntitled