Dog Adoption Application (for former Pet Harbor dog adopters)

I am applying to...*
- Adopt a dog. I have never adopted from Pet Harbor Rescue before.
- Adopt a dog. I have adopted from Pet Harbor Rescue over a year ago. (If it has been less than a year, this application is not necessary.)
Dog Apply
Stop completing this form now and go to the FULL Dog Adoption Application.

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BASICS:
PLEASE NOTE: If you need more space for any response, there is a "Comments" section at the end of the form where you can continue your answer. We are only able to process complete applications. Thanks!
1. What dog(s) did you previously adopt from Pet Harbor?*
2. Has anyone in your home ever been convicted of an animal-related charge?*
- Yes
- No
- Unknown
3. What date are you prepared to actually take a dog home?
Date Format: MM slash DD slash YYYY
4. What is the minimum donation amount currently required to adopt a 2-year-old dog from Pet Harbor?*
For reference, please familiarize yourself with our adoption procedures and contract requirements.

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ABOUT YOU:
Name*
First Last
Has your address changed since your previous adoption from us?*
- Yes
- No
- Unknown
Email*
Address
Street Address Address Line 2 City State ZIP Code
Mailing Address (if different from above):
Street Address Address Line 2 City State ZIP Code
What county do you live in, if any?
COUNTY, not country. Please do not put "USA." If you do not live in a county, please enter "N/A."
Have any phone numbers belonging to any household members changed since the prior adoption?
- Yes
- No
- Unknown
Home Phone (if new)
Cell Phone (if new)
If there is a change in a second cell phone number, please indicate in "Comments."
Work Phone (if new)
If there is a change in a second work phone number, please indicate in "Comments."

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ABOUT YOUR FAMILY, INCLUDING PETS
Have there been changes to the people who live in the home since you first applied to adopt from us?
For example, is there now a baby who wasn't there before or has someone moved out?
- Yes
- No
Please describe those changes.
Have there been changes to the pets who live in the home since you first applied to adopt from us?
For example, has a pet passed away or have you gotten a new pet?
- Yes
- No
Please describe the changes.

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ABOUT YOUR HOME:
No changes indicated.
Please proceed to the next section.
Type of Home:
Length of time at this address.
If your homeowner's association has restrictions regarding pets and/or fences, what are the restrictions?
Do you have a fully fenced-in yard at your current address?
- Yes
- No
Type of fence.
Fence height at its lowest point.
If your exact fence height (at its lowest point) is not listed, pick the one that comes closest.
At your current address, do you:
We will obtain written and verbal permission that the homeowner and homeowner's association allow this pet.
Do you have a homeowner or condo association?
- Yes
- No
Name of apartment complex.
Name of homeowner or condo association.
Homeowner or Condo Association Phone Number or Website:
Landlord's Name
Landlord's Phone Number or Website:
Do you go to the same veterinarian you did when you previously applied to adopt from us?
- Yes
- No
- Unknown
Veterinarian:
Please list your veterinary clinic or hospital name. This is for current and/or prior pets up to 5 years ago. If you have had more than one vet, please explain in "Comments."
Veterinarian Phone

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COMMENTS:
Please elaborate on previous questions or provide additional information that you wish for us to consider in placing a pet with you. Here is your chance to personalize this application.

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Read Carefully. By indicating yes and submitting this form, I signify that all information given in this application is true and correct, to the best of my/our knowledge and that I am of legal age (minimum 18 years) to enter into a contract. And by indicating yes and submitting this form, I hereby further grant consent to Pet Harbor and its volunteers to seek information about the members of our household from all named and unnamed sources within this application, including but not limited to veterinarian, rental agent, personal references, to assist in the application process.*
Your interest is deeply appreciated because every Siberian Husky we can place in a home is one less that is homeless, hungry, abused, or killed. PET HARBOR WOULD LIKE TO THANK YOU FOR TAKING THE TIME TO COMPLETE THIS APPLICATION. Secondhand pets give first-class love.
- Yes
- No
Name
This field is for validation purposes and should be left unchanged.

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Dog Apply