Date

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Name *

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Email Address *

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Home Phone *

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Cell Phone

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Street Address

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City State Zip Code

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How long have you lived at this address

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Date ready for adoption

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Do you rent or own

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Residence Type
housecondoapartment
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Does your lease allow pets
YesNoNot Applicable
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List number of adults living in your household along with names and relations and ages

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List number of children living in your household along with names and relations and ages

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Temperament of children

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Is anyone in your household have known allergies to pets

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Do all adults work full time

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Do you have a private yard
Yes
No
I do not have a yard

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Is your yard fenced
Yes
No
I do not have a yard

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Number of hours a day will your dog be alone

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Where will your dog stay when he or she is alone

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Do you have a dog house
Yes
No

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Do you have pets currently
Yes
No

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What information can you tell us about your current pets

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Have you had any pets in the past
Yes
No

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What happened to previous pets if answer is Yes

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Name and Phone Number of Veterinarian

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Have you ever brought a pet to an animal shelter
Yes
No

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Please describe circumstances if answer is Yes

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Halfway Hounds adoption fee Is a minimum of $250, but can be more depending on the expenses associated with each dog.

Is an adoption fee listed above acceptable to you
Yes
No

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Adoption fees help cover the costs of vet fees, training and transport costs incurred for rescuing this pet (Halfway Hounds is a non profit volunteer based 501c3 with all donations go directly towards helping homeless pets)

This pet is for

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How long have you been looking to adopt a pet

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What type of dog are you looking to adopt

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Are you or have you been a breeder
Yes
No

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Are you a licensed breeder if answer is Yes
Yes
No

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Do you have any breed or size restrictions

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What breeds do you like best

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Was there a particular pet online that interests you
Yes
No

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Please list the name of pet that you are interested in online if applicable

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What characteristics are you looking for in a pet

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How do you plan on exercising your pet

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How do you plan on training your pet

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Tell us anything else about yourself that you think might help us match you with the right pet for you

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To be considered for one of our adoptable dogs, the following must be completed:


1. Proof of current address


2. Proof of home ownership or a lease stating you have permission to have pets


3. The entire family, humane and canine, must meet the dog


1. I hereby acknowledge the information provided in this application is up-­to-­date and accurate.


2. I understand and agree that representatives of the Halfway Hounds reserve the right to inspect my home.


3. I understand that I will be required to pay an adoption fee in accordance with Halfway Hounds’ current fee schedule as well as a mandatory microchip registration fee of $20, which Halfway Hounds will obtain on behalf as the adopter. In addition, I agree to reregister the animal(s) in my own name within one week of adoption.

Agreement Date

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Signature

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