Canine Adoption/Foster Application
Please anser all questions.
Incomplete applications will not be processed.
**We are having problems with applications submitted using certain web browsers! After submitting an application PLEASE EMAIL us at hsarapps@yahoo.com to make sure your application went through!
Please note:
If this is a rental we require a signed landlord release form before the adoption can be finalized.
If your physical address differs from your mailing address, please list both.
Have you ever turned a pet into a shelter?
Please hit the submit button below. Your application will be reviewed and we will get back with you as soon as possible. Please understand that our organization is made up entirely of volunteers and we can't always get to these applications the same day they are submitted.
Are you willing to let a Heartland Small Animal Rescue Representative visit your house prior to adoption?
If you move, are you willing to take your pet with you?
How long will your pet be left alone daily?
Are all of your pets spayed/neutered?
Are your dogs on Heartworm preventative?
Veterinarian used for your pet(s) (if you do not currently have pets, please list the vet used for your previous pets). List name of clinic, phone number, address, name(s) of pets treated here, and name the account is under.
Animal I am interested in:
Name of Applicant(s):
Street Address:
City:
State:
Zip Code
Home Phone:
Cell Phone:
Email Address:
Employer
Work Phone Number:
Who, besides you, resides in your home (name, age, relationship, and whether it is part or full-time):
Please list your current animals (name, species, sex, breed, and age)
Please list all your animals you have owned in the last 5 years, not including current animals) (name, species, breed, sex, age and where they are now).
Please describe your yard (approximate size, fenced or not--having a fenced in yard is not a requirement):
Where will this pet be kept when home alone (crate, specific room, free roam of the house, etc):
Will this pet be primarily an indoor or outdoor dog?
How will your dog be let out for bathroom breaks/exercise? (Tie out, run, fenced yard, kennel, etc):
How much are you willing to spend on vet care annually for this pet? What will you do if the bill goes over this amount?
Does anyone in your house suffer from asthma or allergies?
Who will be responsible for the care/training of this pet?
Where will your pet sleep at night?
If you go on vacation or have an emergency, who will care for your pet?
What provisions would you be willing to make for your pet should you become unable to care for it?
Under what circumstances would you consider turning a pet over to a shelter?
How did you hear about us?
Personal Reference (please list name, relationship, address & phone number or email):
