First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
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Email*

Home Phone

Cell Phone*

Legal Name (for background check):*

Date of Birth*

Employer, Position, and Years with Company*

Which animal are you interested in adopting? (If you have not chosen a specific animal, please select DOG or CAT, based on which species you want to adopt.)*
Choose an animal: Angelo Bandit Ben 10 Boyce Bristol Cassie CAT Charlotte Diesel DOG Gertie Goldie Grimm Huck Katie Kyah Lemon Melina Mindy Nix Queenie Sandra Smitty Smokey Sophie Sparticus Stacey Stash Tawny Teagan Tripp Walter Jr Willa

If your first choice of animal is not available or is not a good fit, do you have a second choice animal in mind? If so, choose that animal's name here.
Choose an animal: Angelo Bandit Ben 10 Boyce Bristol Cassie CAT Charlotte Diesel DOG Gertie Goldie Grimm Huck Katie Kyah Lemon Melina Mindy Nix Queenie Sandra Smitty Smokey Sophie Sparticus Stacey Stash Tawny Teagan Tripp Walter Jr Willa

If you are not interested in one of our current available animals and have chosen the entry DOG or CAT, please enter any specific preferences you have here.

Why are you interested in adopting this particular animal?

Are you currently looking at other animals with other organizations and/or do you have any active applications for animals with other organizations? (If so, we ask that you notify us if you no longer want to adopt the animal you are applying for here.)*

Do you currently have other animals in your home?*
Choose one: Yes No

Please list name, breed, and age of all animals in your home, if applicable.

Name and phone number of veterinarian. (If you don't currently have animals, please provide the information for the vet you have used in the past.)

Do you give permission to Hero's Haven to contact your veterinarian to verify vaccination status, medical history, and spay/neuter status of current pets? (Failure to grant permission will results in automatic denial of application.)
Choose one: Yes No

Are your current pets spayed/neutered?
Choose one: Yes No

Are your pets current on all their vaccinations?
Choose one: Yes No

If you have a dog/dogs, are they on heartworm preventative and/or have they had a negative heartworm test within the past year?
Choose one: Yes No

Are your current animals on flea/tick preventative?
Choose one: Yes No

Are you committed to the time and expense of emergency medical care for your animal?*
Choose one: Yes No

Please list the names and species of any pets you have had in the home in the last five years that you no longer have. Include why they are no longer in the home.

Have you ever adopted from a rescue or shelter before?*
Choose one: Yes No

Who will be responsible for feeding the animal?*

Where will your animal be kept when it is home alone?*

Where will the animal sleep at night?*

How will your cat/dog be taken care of when you are traveling?*

How many hours per day will the animal be left alone?*

Will your animal live inside your home and only be allowed outside with proper supervision and containment?*

How do you plan to exercise and entertain your animal?*

Animals need time to adjust to new environments and need a family who will have the patience and understanding to let them do so at their own pace. Are you willing to commit the time it may take for this adjustment?*

Some of our animals may be housebroken/litter-trained while they are in foster homes. However, animals sometimes will have accidents when they change environments. Are you willing to spend the time housebreaking your animal, even if you believe them to already be housebroken at adoption?*

If you are applying for a cat, how do you plan to deal with the possibility of destructive scratching?

What behavior would you consider unacceptable and cause you to return your adopted animal?*

What is your housing type (house, apartment, etc.) and do you own or rent?*

How long have you lived at your current address?*

If you are under the restrictions of a homeowner's association, have you checked to ensure there are no breed/size restrictions for animals? (If no HOA, enter n/a.)*

If you rent, please provide the name and number of your landlord or management company.

If you are applying for a dog, do you have a fenced-in yard? If yes, please list the type and height of the fence.

Please list the LEGAL name and date of birth of all adults in the home. If you have children in the home (full time or part time), please list only their ages.*

Please list the name and phone number for three references we can contact about your application. References must be at least 21 years of age. You may only list one immediate family member. We ask that you please inform your references that we will be calling them. If we are unable to get in contact with your references, it could delay the approval of your application.*

MY SIGNATURE BELOW AUTHORIZES THE REPRESENTATIVES OF HERO'S HAVEN TO CONTACT MY VETERINARIAN, LANDLORD, PROPERTY MANAGER, HOMEOWNER'S ASSOCIATION, AND REFERENCES. I CERTIFY THAT ALL THE INFORMATION CONTAINED IN THIS APPLICATION IS TRUTHFUL, AND I UNDERSTAND THAT ANY MISREPRESENTATION COULD LEAD TO AUTOMATIC DENIAL OF MY APPLICATION, OR THE REMOVAL OF ANY DOG ADOPTED TO ME BY HERO'S HAVEN IF FALSE INFORMATION IS DISCOVERED FOLLOWING THE SIGNING OF THE ADOPTION CONTRACT. I ALSO CERTIFY THAT I HAVE NEVER BEEN CONVICTED OF ANY KIND OF ANIMAL-RELATED OFFENSE (including, but not limited to, animal abuse, cruelty, or neglect). I UNDERSTAND THAT HERO'S HAVEN WILL DO A HOME VISIT BEFORE ANY DOG IS ADOPTED TO ME, AND ALL ANIMALS ADOPTED OUT FROM HERO'S HAVEN ARE REQUIRED TO BE SPAYED/NEUTERED. Please type legal name and date in the box provided.*