ADOPTION PROCESS

• Full Name*
  First Last
• Address*
  Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country
• Phone*
• Email*
• Type of Residence?*
  • House
  • Apartment/Condo
  • Moible Home
  • Other
• Do you Own or Rent?*
  • Own
  • Rent
  • Other
• How long have you lived at your current address?*
• If you rent, does your landlord or association permit you to keep a dog?*
  • Yes
  • No
• Please provide your landlord's name and phone number (if own, write SELF)*
• Animal you are interested in adopting? (NAME)
• Please list names and ages of all members of your household:*
• Please list all pets that you CURRENTLY own including: NAME, SPECIES & BREED, AGE & LENGTH OF OWNERSHIP*
• If you own pets CURRENTLY, are they all spayed or neutered? If no, why?*
• Are all pets current on vaccines?*
  • Yes
  • No
  • I do not currently have any pets
• Are all current dogs on heart worm preventative?*
  • Yes
  • No
  • I do not currently have a dog
• If your dog is not current on heartworm preventative, why not?
• Other than those listed, have you owned any other pets in the last 5 years?*
  • Yes
  • No
• If yes, please list PET(s) NAME, SPECIES & BREED, AGE, LENGTH OF OWNERSHIP:
• Do you have a fenced yard?*
  • Yes
  • No
• Do you have a crate to keep a dog in?*
  • Yes
  • No
• How many hours per day will the dog be left alone?*
• Where will you keep the dog while you are at work or on errands?*
• Where will you keep the dog while you are on vacation?*
• Will the dog be allowed on furniture?*
  • Yes
  • No
• Where will the dog sleep at night?*
• Does anyone in your home suffer from allergies or asthma?*
  • Yes
  • No
• Why are you interested in adopting this particular dog?*
• Do you have a preference for sex, color or age? If so please describe:*
• Please provide us with a veterinary reference including phone number*
• Please provide us with a personal reference including phone number*
• Do you agree to a Tender Heart Representative visiting your home prior to and/or after adoption?*
  • Yes
  • No
• Are you willing to enroll the dog in obedience class or other training if you experience behavior problems?*
  • Yes
  • No
• Do you understand the dog should never be allowed off leash in open places?*
  • Yes
  • No
• Have you ever owned a rescue animal?*
  • Yes
  • No
• Do you understand all of the expenses involved with caring for a dog especially as it ages, including but not limited to ordinary & emergency vet expenses, heart worm preventative, dental care, grooming, etc.?*
  • Yes
  • No
• All of our dogs are spayed/neutered, vet-checked, up to date with shots and evaluated before they are placed. Adoption fees vary. Do you understand the need for this donation and that fact that all donations are non-refundable?*
  • Yes
  • No
• Do you understand that there are no guarantees about the house training, behaviors, temperment or health of a dog that is adopted and that the adjustment period varies for each dog?*
  • Yes
  • No
• Have you applied with another rescue organization in your seach for a new family member?*
  • Yes
  • No
• Do you currently have an application submitted with another rescue*
  • Yes
  • No
• I applied but did not adopt from another organization*
  • Yes
  • No
• I have never applied with another rescue organization*
  • Yes
  • No
• I have adopted through another rescue organization in the past*
  • Yes
  • No
• All applications are subject to a home visit. We reserve the right to refuse or reject any application before or after an animal has been placed. If placement does not work out by an adopter, animal MUST BE RETURNED TO TENDER HEART CHARITIES INC. By clicking submit, I agree that I have read the above information carefully and have filled out this application honestly. I understand that any omission of information and/or failure to answer all questions can result in this application being denied. If falsification or an omission of information is discovered after an adoption takes place, I understand that Tender Heart Charities Inc., reserve the right to annul the adoption and reclaim the animal. I give the Tender Heart Charities permission to investigate all information provided, including conducting a background check, as well as contacting my references. I understand that it is the goal of Tender Heart Charities is to place animals in loving forever homes, best suited to the animal’s needs, and as such, my application can be denied at any time for any reason.
• Signature*