Adoption Application Form - Homes For Huskies Rescue Inc

Primary Applicant Details

Name*

Prefix First Last

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone*

Email*

How often do you check your emails?*

Employment*

Age*

Primary Applicant must be over 21.

Co-Applicant Details

Name

Prefix First Last

Email

How often do you check your emails ?

Your Household

How many adults currently live in your household?*

Please enter a value between 1 and 10.

How many children currently live or regularly visit your household?*

Please enter a value between 0 and 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?*

Yes
No

What type of residence do you live in?*

Do you own or rent your residence?*

Rent
Own

Do you have the landlord's permission to keep a dog?*

Yes
No

Landlord reference: Organization - First Name - Surname - Phone - Email

Which 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?*

Do you have a pool?*

Yes
No

Is your pool fenced and secure ?

Yes
No

Fences

How high are your boundary fences and gates?

What are your boundary fences constructed of?*

Photos of Back fence:

Drop files here or

Photos of Right Side fence:

Drop files here or

Photos of Left Side fence:

Drop files here or

Photos of any Gates:

Drop files here or

Any other photos showing fencing:

Drop files here or

Breed Experience

Have you ever owner a Siberian husky, Siberian Husky X or any Arctic Breeds?*

Yes
No

Details 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 above

Any other experience/research not listed above ?

Do you have any experience training and working with dogs with behavioral issues? Please give details.

Past Pet Ownership

How 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 Ownership

How many cat’s do you currently own?*

Please enter a value between 0 and 10.

Are your cat(s) inside, outside cats or both?

Inside
Outside
Both

Are your cat(s) declawed?

Yes
No

Has the cat(s) ever interacted with dogs?

Yes
No

Please describe your cat(s) interaction with dogs.

Current Canine Ownership

How many dogs do you have ?*

Please enter a value between 0 and 10.

Name – Sex – Age – Breed

Has your dog(s) been C5 vaccinated within the last 12 months?

Yes
No

Is your dog desexed? If not, is there a reason?*

What is your dog's temperament, socialization and activity level?

Veterinarian Information

Do you have a regular Veterinarian?*

Yes
No

Organization – vets name – phone number

Is this the vet you currently use?

Adoption Information

Do you currently own any pocket pets/other animals? Please list how many and breed.*

If you are interested in a specific dog on our website, please indicate which one(s)*

If you have listed specific dog(s) you are interested in, please tell us one thing about each dog that sparks your interest

Why have you chosen a Siberian husky?*

Energy Level Preference*

Why do you want a dog?*

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.*

Are you looking at other breeds of dogs? If so please indicate which breeds and what draws you to those breeds.

Do you plan on letting your Husky off-lead in unfenced areas?*

Yes
No

Are you prepared for regular grooming?*

Yes
No

Please tell us what you know about the Siberian Husky breed.*

The New Dog

Where 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.

Home Visit and Agreement

Where did you hear about us?

Do you agree to let a representative of Homes For Huskies Rescue Inc. visit your home by appointment?*

Yes
No

If No, why not ?

I/We understand that EVERYONE IN THE FAMILY, INCLUDING OTHER PETS, MUST BE PRESENT AT HOMECHECKS AND THE POTENTIAL ADOPTION APPOINTMENT, NO EXCEPTIONS. I/We hereby authorize through submission of this form, any veterinarian named above to release any information and records concerning my past or present care of animals to Homes For Huskies Rescue Inc. and I do hereby agree to hold harmless and indemnify said veterinarian for providing such information. I/We understand that shall the adoption not work out, for any reason, the dog will not be given away, sold or put in a shelter but will be returned to Homes For Huskies Rescue Inc. I/We further understand that completing this application does not guarantee that a dog will be placed with me. 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 contract if a dog is placed with my family. 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 Agree
I Disagree