We are a Rescue Shelter that helps homeless animals find a new forever home. In order for us to help these animals we need you to help us by donating today. Wish List: Dog food, cat food, straw, towels, bleach, paper towels, etc....
Please help us help them by donating today!
To apply for the adoption of an animal, please copy the below application, fill out all the required information, and email it to us at firstname.lastname@example.org
We must receive and approve the application before we move forward with adoptions.
Help Us Help Animals
ALL ADOPTION FEES CASH ONLY.
My Date of Birth:_______________________
WE CHECK TO SEE IF YOU OR ANYONE IN YOUR HOUSEHOLD HAS BEEN ARRESTED FOR USING OR SELLING ANY KIND OF DRUGS.
ALSO CHECK IF THERE HAS BEEN ANY DOMESTIC BATTERY, CHILD MOLESTING OR CHILD ABUSE, AND ANIMAL ABUSE, TORTURE, NEGLECT OR CRUELTY ARRESTS OF ANY KIND.
I wish to adopt a dog or other Animal because:________________________________________
Personal references not related to you ( Please list name,phone):
About you and your household--please check appropiate box (x):
**Are you: ( )Working, ( )Homemaker, ( )Retired, ( )Attending School, ( )Other
**Type of Housing:( )Home, ( )Condo, ( )Apartment, ( )Mobile Home, ( )RV,
( )Own, ( )Rent, ( )Live with parents, ( ) Rent lot space, ( )Other:
** Landlords Name:__________________________Phone________________
** Others in household:_____________________________________________
ALL ANIMALS IN HOUSEHOLD MUST BE SPAY OR NEUTERED BEFORE ADOPTING A NEW PET FROM THE HELP US HELP ANIMALS.
**My experience with Dogs: ( ) First time, ( )Had one or two, ( ) Very experienced
**Do you have other pets now? ( )Yes, ( )No, If yes: ()Cat, ( )Dog Breed________
___________________ ( )other______________________________________
Where did you get your pet?________________________________________
Length of time you have had your pet:_________________________________
Spayed/Neutered? ( )Yes ( )No
** If you Dont have a pet now, Have you ever had a pet before? ( )Yes ( )No
If yes: ( )cat, ( )dog breed______________spayed/neutered?( )yes, ( )no
Length of time you had the pet:______________what happened to pet?______
**Have you ever adopted a pet from Help Us Help Animals before? ( )yes ( )no
**Size of dog I'd like: ( )small (up to 20lbs) ( )Med (20-50 lbs) ( )Large (50-100lbs)
( )Giant (over 100 lbs) Prefer ( )male ( ) female ( )either
**I'd like these personalities/Temperament Traits in my dog: ( )Quiet ( )Mellow
( )Affectionate ( )lap dog ( )protective ( )vocal ( )herder ( )retriever ( )loves water ( )other:________________
**Training preferences: ( ) none, ( )some obedience, ( )housebroken, ( )fully trained
**For exercise I prefer a dog that: ( )walks on a leash, ( )Walks on & off leash,
( )Will run or hike with me ( ) Will exercise itself ( )Requires no exercise
**I prefer a dog with an energy level that is: ( )high, ( )Moderate, ( )Low
**Ipresently have: ( )A fenced yard, ( )an enclosed kennel, ( )A stationary Tie-up,
**My dog would be (where):________________________________during the day, and (where)___________________________________at night?
I understand the Help Us Help Animals is under no obligation to adopt the animal described in this application to me for any reason whatsoever. I further understand that representatives of Help Us Help Animals will contact the references listed above for suitability for adoption and pet ownership. If I am approved for adoption, I agree to execute an Adoption Agreement and be bound by the terms thereof.
The Help Us Help Animals makes sure that all animals that come to our rescue is vaccinated, dewormed, and defleaed.
I also understand it is my responsiblity to take the animal I adopt to my veterinarian to have a complete physical checkup.
I also understand that there is a risk of cross contamination of animals that the Help Us Help Animals comes across and bring to their shelter. I understand it is not Help Us Help Animals fault if the said animal I adopt from them has an illness or skin condition that not is noticed by the naked eye. It is the original owners fault that they did not properly take care of their animal.
I also understand there is No Refund of the said dog or cat or other type of pet animal if it has to be returned to the Help Us Help Animals.
The undersigned releases and holds harmless the Help Us Help Animals its employees, agents, officers and directors, from any and all liability which may arise out of any verification of the information contained herein. Help Us Help Animals agrees that it shall keep information received from such verification confidential.
The undersigned further releases and holds harmless the veterinarian(s) listed on the reverse side thereof, and such veterinarians clinic, employees, agents, officers and directors, from any all liability which may arise from information conveyed by such veterinarian or such veterinarians clinic, employees, agents, officers and directors, to the Help Us Help Animals as a result of inquiries made in connection with this Adoption Application.
(Adopters Signature) or type in if filling out online
where did you hear or learn about this animal?
( )Newspaper Ad ( )Shelter Web Site ( )Petfinder.com ( )Referral ( )Drop-In Other:______________
(For Help Us Help Animals employees to complete):
Application: ( )Approved ( )Denied Date:_____________________
Reason for denial:
Background Check completed: ( )
We are a rescue shelter who helps homeless animals find new forever homes.
MUST FILL OUT APPLICATION FIRST THEN WE DO BACK GROUND REFERENCE CHECK AND IF EVERYTHING COMES OUT GOOD WE SCHEDULE FOR YOU TO COME OUT TO MEET A HOMELESS PET. WE ALSO DO HOME CHECKS.