Dog Adoption Application Form
Applicant's First Name
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Applicant's Last Name
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Date of Birth
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Email Address
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Full Physical Address
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City
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Mobile Number
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Alternate Phone Number
Employment Status
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Full-Time
Part-Time
Retired
Work from Home
Stay at Home Parent
Student
Unemployed
Other
Employer Name/Work place
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Do you own or rent your home? If you rent you will need to email us adoptions@hhar.org.nz with landlord contact details, and proof that you are allowed a pet.
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Own
Rent
Owned by Family
Are you a NZ Citizen/Resident?
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No
Yes
Emergency Contact Details:
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Please provide Name, Gender, Age and relationship to you of everyone else living in your home
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Please provide details of other pets living in your home. Name, Breed, Sex, Age, Desexed Y/N, Current Vax Y/N, Registered Y/N
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Do your current animals have any behavioural issues? Examples of this are fear, reactivity, aggression towards other animals etc. Please explain what these are and the steps you are currently taking to help this.
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Please list previous dogs owned/time owned for
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Does anyone in your household have allergies to dogs/cats?
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Yes
No
Possibly
N/A
Have you ever had to rehome or euthanise a pet? Please provide details or put N/A
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Please describe your current residence. Provide details on fencing such as height & material. Are you urban or rural?
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Please explain why you are looking to adopt a dog
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Please describe the kind of dog you are looking to adopt. Age, sex, size etc. If you are applying for a specific dog on our website please input their name(s).
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Would you describe yourself as an experienced dog owner?
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No
Yes
On average, how many hours per day will your pet be left alone WITHOUT human company?
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If no-one is at home, where will the dog stay? Inside or Outside? If the dog is outside, what type of shelter will the dog have?
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Will this pet be predominantly living inside, outside, or both? If allowed inside what areas of the house will it be allowed to access?
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Are you willing and able to exercise the dog on a regular basis? Please provide details
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Are there times when the dog will be tied/chained up? If yes please explain
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Where will your new dog sleep? Please be specific eg kennel, verandah, laundry. If inside, which room?
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How will you handle basic training such as toileting, waiting, crate training, leash training etc.
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Sometimes when dogs are decompressing in a new home, destructive or aggressive behaviours can surface. How will you deal with that should the situation arise?
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For what reason(s) would you consider returning/giving up the dog?
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Are you willing to take responsibility for this animal for the next 10-20 years?
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No
Yes
Please provide details for one personal reference or veterinary reference. Name, relationship to you, phone number, email address
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Please tell us more about you, your family, hobbies, this is your chance to tell us whatever you would like. The more information you provide, the better we will be able to determine suitability.
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I will email property photos or video to adoptions@hhar.org.nz on completion of this application. If I am unable to do this I will notify the rescue immediately so they can organise to have an in person check done.
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No
Yes
If an adoption proceeds do you want us to sign you up for 30 days of free pet insurance?
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No
Yes
I certify that the answers I have given are complete, true and not misleading in any way. I understand that by selecting yes I am agreeing to the adoption terms/conditions. I understand that by selecting yes I am not committing to an adoption.
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No
Yes