New Hope Rescue
Adoption application--
Your name:
Is there a specific animal you
would like to adopt? Please
give name/ description:
Who will be the primary caretake of this pet?
Why is this a good time to adopt?
Marital status: (Married,
single, divorced, widowed)
Number of adults in the home:
Number of children/ages:
Does anyone in the home have asthma/allergies?
Are you looking for an indoor pet or one that only
stays outdoors?
Do you anitcipate any major lifestyle changes
(marriage/new baby/moving)? Please explain.
What would happen to your pet if you had to
Who will take care of your pet when you are away
How many hours a day will your pet be left alone?
Do you own a home or rent?
If you rent, is it a house, apartment, townhouse?
Are there any size/breed restrictions in your
lease? Please provide the landlord's contact
Do you have a fenced yard? What type (chain link,
privacy, invisible)?
Tell us about your most recent pets and if they
are still with you, or what happened to them.
Have you ever been reported to Animal Control?
Tell us what the circumstances were and the
Please list your current veterinarian and contact
number and 3 references with phone numbers.
I certify that all the above information is true and I recognize that any misrepresentation of facts may result in
loss of my adoption privileges.

I authorize verification of all statements in this application with the listed veterinarian, references and landlord.

New Hope Rescue reserves the right to refuse an adoption to anyone who, in its opinion, will not provide a
suitable home for this pet.