Help Orphan Puppies, Incorporated

Adoption Application

First name

Last name

Phone

Birthday

Month

Day

Year

Address

Employer

Position

Name and relationship of adults in the home (18 years of age and older)

Name, age and relationship of children in the home

Do you currently own any pets?

Yes

If you own any pets, please list the type of pet, age, and if altered

Please list any pets previously owned, if they were altered, and what happened to them

Do you own or rent?

Own

Rent

If you rent, please note your landlord's name, address and phone number so that we may contact them.

Do you have a completely fenced in yard attached to your home?

Yes

Please describe your fence height and type

If you do not have a fenced in yard, please describe how you plan on keeping the dog in your yard for bathroom breaks and exercising.

Where will the dog live during the day?

Inside the house, loose

Crated inside the house

Outside in a kennel

Where will the dog live at night?

Inside the house, loose

Crated inside the house

Outside in a kennel

Will you attend obedience?

Yes

Please name the dog or dogs you are interested in. If there is not a specific dog, please note n/a

Please provide the name and contact information for your vet including name, address, phone number and name on the account

Please provide three references, including name and phone number. Please do not include individuals related to you.

If an adopter is unable to keep the dog for its lifetime, the dog MUST be returned to Help Orphan Puppies under the conditions specified in the adoption contract. By providing my digital signature below, I acknowledge that I have completely read the Application, comprehend it fully, and know that applying does not insure approval. I also understand that Help Orphan Puppies reserves the right to disapprove any applicant for any reason and that untruthful answers or failure to comply with the requirements of this Application, the Foster Contract, and/or the Adoption Contract may result in forfeiture of any Help Orphan Puppies pet which may be fostered and/or adopted by me. By providing my digital signature, I further acknowledge that all information contained in this form is true and correct to the best of my knowledge. I further acknowledge that I have read and meet the adoption requirements noted on this website. I understand that any misrepresentation of fact will result in the removal of my adoption application. Please enter your digital signature below:

Signature

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