Please fill out and email back to newhopepetrescue@gmail.com. All adoptions done on a first approved basis!!

New Hope Pet Rescue Foster Application CONTACT INFORMATION: Full Name: ____________________________________________________________ Address: ______________________________________________________________ Time at residence: _____________________________________________________ Daytime Phone: _______________________________________________________ Evening Phone: _______________________________________________________ Email Address: _______________________________________________________ EMPLOYMENT INFORMATION: Place of Employment: _________________________________________________ Occupation: __________________________________________________________ Time at this Job: ______________________________________________________ Supervisor Name: _____________________________________________________ Work Phone: _________________________________________________________ FAMILY AND HOUSING INFORMATION: Number of adults in your home (their relationship to you): ____________________ Number of children in home (ages): _______________________________________ What type of home do you live in (circle one) Single family Apartment Describe your household (circle all that apply) Active Noisy Do you own or rent (circle appropriate) Rent

Townhouse

Farm

Quiet

Average

Own
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Please fill out and email back to newhopepetrescue@gmail.com. All adoptions done on a first approved basis!!

Renters: Please provide your Landlords name and Phone number:

By providing this information you are allowing New Hope Pet Rescue to contact Landlord; failure to provide this information will automatically disqualify you from adopting with us!!

Does anyone in the family have a known allergy to dogs (circle one) YES NO Is everyone in agreement with the decision to adopt a dog (circle one) YES NO Do you have time to provide adequate love and attention (circle one) YES NO Please elaborate on the household schedule (include time dog will be alone)

OTHER ANIMALS IN YOUR HOME: What other pets do you have in your home (specify type and number): ___________________ Are all of your pets up to date on vaccines (circle one) YES NO Are all of your pets spayed/neutered (circle one) YES NO Have you ever surrendered a pet (circle one) YES Have you ever euthanized a pet (circle one) YES

NO

WHY?________________________

NO

Why?_________________________

Have you ever lost a pet to an accident (circle one) YES NO

Why? ________________________

How do you discipline your pets: __________________________________________________

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Please fill out and email back to newhopepetrescue@gmail.com. All adoptions done on a first approved basis!!

VETERINARIAN INFORMATION: Do you have a regular vet (circle one) YES NO Veterinarians Name and Address: _______________________________________________ Veterinarians Phone: __________________________________________________________
By providing New Hope Pet Rescue with this information you are allowing us to call your vet. Failure to provide this information will disqualify you for adoption.

ABOUT THE DOG YOU ARE LOOKING FOR: What is your ideal dog and why: _________________________________________________ Desired age ___________________ Desired Breed: _______________________ Desired Size _____________________________ Desired Sex (circle one) M F

Are you willing to adopt (circle all that apply) Outgoing/hyper Shy Need Training Where will your dog spend the day (circle one) Crate Free Roaming Where will your dog spend the night (circle one) Bed with you Crate

Needs Grooming

Other: ________________________

Other: ________________________

Number of hours dog will spend alone (average): _____________________________________ Who will be primarily responsible for dogs daily care: _________________________________ Who will be financially responsible for dog: _________________________________________ Do you agree to provide regular health care by a Licensed Veterinarian (circle one) YES NO Do you agree that this dog will be mainly an indoor dog (circle one) YES NO When the dog goes out how will he/she be supervised (circle one) Fenced Yard Leash Tie Out

Other: ______________

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Please fill out and email back to newhopepetrescue@gmail.com. All adoptions done on a first approved basis!!

Do you agree to contact New Hope Pet Rescue if you can no longer keep this dog (circle one)
By circling yes you are indicating that you understand that New Hope Pet Rescue will NOT issue a refund for the adoption fee or any other costs incurred if the need to return to dog arises.

YES

NO

Are you willing to let a representative of New Hope Pet Rescue visit your home by appointment (circle one) YES NO How did you hear about New Hope Pet Rescue: ______________________________________ PERSONAL REFERENCES: PLEASE LIST THREE INDIVIDUALS FAMILIAR WITH YOU AND YOUR PETS.
NON-FAMILY MEMBER. Name: Address: Phone: Relationship (circle one) Relative Neighbor Friend ONE MUST BE A

Name: Address: Phone: Relationship (circle one Relative Neighbor Friend

Name: Address: Phone: Relationship Relative Neighbor Friend

All of the information I have given is true and complete. I understand that any misrepresentation or dishonesty may result in civil action being taken against me. I understand that I will have to sign an Adoption Contract and pay non-refundable adoption fees prior to adopting a dog from this rescue.

__________________________________________ Signature

_______________________________ Date

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