First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

Email*

Home Phone*

Work Phone
x

Cell Phone

Alt Email

If your Mailing address is different than your physical address please list it here.

Spouse/Partners Name

Name of Animal applying for:*
Choose an animal: Archie Aries Beckett Bentley Bonita Chelsea Clementine Coralie Dalton Davina Dove Ellie Fiona Frida Georgie Graham Grier Jude Juniper Kona Kylie Lainey Luna Minnie Molly Nico Popi Roscoe Roux Silas Suzie

Describe the kind or type of pet you are looking for. PLEASE be specific on what you DO or DON'T want in a new companion.

What's your living situation?

Do you own or rent your home*
Choose one: Rent Own

If you answered Rent to above question please supply Landlords' name and Phone number, as we will contact them.

What is your age? List the age of each person in the home? *

Is everyone in the home agreeable to bringing a new rescue into the household & family?

Please note you must be 21 to apply for any cat.

Does anyone have allergies to animals?

Where would this cat spend their time?*

Are you planning to declaw
Choose one: Yes No

Do you have any pets currently?

If you answered Yes to the above question, please list their: Name, Species, Breed, Gender, Age, How long owned.

What is your Veterinarian's Office name and phone number? PLEASE CALL your vet to verify that your current pets are current with DHPP & Rabies vaccines and that they are Spayed/Neutered. If you have intact dogs or cats, we will not approve your application. *** If you do NOT have an established Veterinarian please provide the information for the practice you intend to use and let us know you have no history yet.*

If you entered a vet name above please enter the phone number here.

As an Adult, have you ever owned a pet in the past that is no longer with you?

If you answered Yes to the above question, please provide the Breed, Ending Date, What became of them (passed away, gave away etc)

What BRAND of pet food do you feed (if you have pet(s) now) or plan to feed?

Are you financially prepared to provide the necessary care for your new pet including proper food, vaccinations, parasite control (fleas, ticks, worming) licensing, veterinary care for yearly checkups or emergency visits?

Do you have a plan for your pet if you become unable to care for them? Examples: Unable to care for yourself, End of Life, Loss of employment/income, Loss of home, Employment requires a move out of state/country? Please be specific. *

Have you ever given up a pet? If yes, please explain*

Anything else we should know about you and your family lifestyle?

Please list two (2) Personal references - Name and phone number.*

Please tell us how you found out about Collar of Hope (example: Facebook, Petfinder, Adopt a Pet, etc....) We would like to know where we are being seen the most.

I understand by submitting this application, I give Collar of Hope permission to contact my landlord if applicable, permission to contact my Veterinary reference and permission to contact my personal references listed.

Please remember we are an all volunteer rescue. This means we are all splitting our time between our families, pets, jobs to schedule times to save lives and find them forever homes. While we understand things change please notify us as soon as possible if you can not make a agreed upon appointment time. Thank you, Collar of Hope volunteers

All of the information I have given above is true and complete. I understand that any misrepresentation of the above information authorizes Collar of Hope to deny application, and/or reclaim the pet that is in my home. I understand Collar of Hope will furnish all known information about a dog but as dogs in different environments and with different handlers, dogs can react or behave differently. I understand completely that it is our responsibility to evaluate the dog myself before agreeing to adopt it. Collar of Hope is in no way liable or responsible for any damage, accident or injury resulting from the placement of a dog in my household.

Name of person completing the application?