First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
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Email*

Home Phone*

Work Phone*
x

Cell Phone*

Alt Email

Text/Pager Email

Place of Employment:*

What animal are you interested in adopting, name:

Which animal are you interested in
Choose an animal: Blackie Brownie Greyson Jack Kai Max Pre Approval Application Rocky Vito

Why are you interested in adopting a pet at this time*

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

Have you ever been charged with a crime against animals?

What traits are you looking for in a pet

Please describe the type of situation where you might have to return your adopted pet to Our Last Hope Animal Rescue? ie: allergies, job loss, move, marital change etc… *

If other pet in home please list:*

Are all the animals in your household altered? If NO explain:*

Will the animal be kept inside or outside

Where will the animal be kept when you are not home*

Where will the animal be kept when you are home*

Where will the animal sleep*

How much time will the animal spend alone during the day*

For cats only: Are you planning to declaw

Describe how you will train the pet*

List at least two reference (who is not a family member)*

Veterinarian's Name and Phone Number*

Have you applied with any other rescue

How did you hear about us*

If you rent, please enter your landlord's name and phone number*

If you rent, have you received the approval of your landlord to have an animal

Do you own or rent your home

How long have you lived in your current residence?*

How many people reside in your household*

Are there children under the age of 8 years old in the home?*

Who in the household will care for the pet*

In what type of home do you live

Is your yard fenced

What type of fence

What is the height of the fence*

Do you understand that you may be asked to provide this animal with needed medication and/or preventative medication?

Are you aware that you can contact OLHAR after the adoption to ask questions or to obtain training assistance or guidance for this pet?

Do you understand that if at any time during the life of the pet, you are unable to keep it that you must return the pet to Our Last Hope Animal Rescue at your own expense? You may NOT take it to an SPCA, City Pound, surrender to another rescue group, or give it away or sell it to another group or person.

**Non-Refundable fee acknowledgment** The fee is not a sale price but a request to defer or reimburse RESCUE for any expenses incurred by the dog or RESCUE to consider the dog for adoption.

I have completed the above application, carefully and answered all the questions honestly. I understand that if I have not completed this application honestly or have omitted important information it can result in this application being declined. I give Our Last Hope Animal Rescue permission to contact my Veterinarian(s) and personal contacts while processing this application. If this application passes review, I agree to a home visit and a yard check on an agreed upon date and time. I also understand that a follow up home visit will be made at an agreed upon date and time.

I certify that the information entered on this applicant is true. Enter your name and date*