HART Adoption Application
Items marked with an * are required fields
A no-kill, non-profit rescue, dedicated to the care and forever placement, of abandoned, adoptable animals for life.
Homeless Animal Rescue Team (H.A.R.T.)
231 North Avenue West, #156
Westfield, NJ 07090
(Cranford/Raritan)
Phone: 908-233-1502
Please answer ALL questions, if you don't, your application will be discarded. |
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Name of the Pet your interested in*:
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First Name*:
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Last Name*:
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Home Phone*:
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Work Phone:
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Cell Phone:
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Street Address*:
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City*:
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State*:
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Zip Code*:
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Email Address*:
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How long have you lived at this address?
How many adults live at this address?
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How many Children live with you and ages?
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Does anyone in your family have allergies?
Yes
No |
Is anyone planning on having a baby in the future?
Yes
No
If so, what will you do with the cat?
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What type of housing?
Apt.
Condo
House
Other |
Do you rent or own?
Rent
Own |
| We must have the Landlords Phone number, to verify that pet's are OK if you rent. | |
If you don't own, and you rent or lease, are pets allowed?
yes
no |
May we contact your landlord?
yes
no
If so, what is the phone number?
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List animals you currently own or that are in your care/house and those you have previously owned, if you need more room list in comment box below:
Dog
Cat
Other
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Name
If other, what:
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Male
Female
Age:
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If Dog, what breed/mix?:
Spay/Neuter
Yes
No
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Housed
Inside
Outside
Both
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How Long
Owned?
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Where is it now, if deceased from what?
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Dog
Cat
Other
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Name
If other, what:
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Male
Female
Age:
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If Dog, what breed/mix?:
Spay/Neuter
Yes
No
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Housed
Inside
Outside
Both
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How Long
Owned?
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Where is it now, if deceased from what?
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Dog
Cat
Other
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Name
If other, what:
|
Male
Female
Age:
|
If Dog, what breed/mix?:
Spay/Neuter
Yes
No
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Housed
Inside
Outside
Both
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How Long
Owned?
|
Where is it now, if deceased from what?
|
Dog
Cat
Other
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Name
If other, what:
|
Male
Female
Age:
|
If Dog, what breed/mix?:
Spay/Neuter
Yes
No
|
Housed
Inside
Outside
Both
|
How Long
Owned?
|
Where is it now, if deceased from what?
|
Dog
Cat
Other
|
Name
If other, what:
|
Male
Female
Age:
|
If Dog, what breed/mix?:
Spay/Neuter
Yes
No
|
Housed
Inside
Outside
Both
|
How Long
Owned?
|
Where is it now, if deceased from what?
|
Dog
Cat
Other
|
Name
If other, what:
|
Male
Female
Age:
|
If Dog, what breed/mix?:
Spay/Neuter
Yes
No
|
Housed
Inside
Outside
Both
|
How Long
Owned?
|
Where is it
now, if deceased from what?
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Do you plan to declaw?
Yes
No
Have you ever owned a declawed cat?
Yes
No
Will the pet be indoors or outdoors or both?
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Do you plan to take your pet outside during the day or night?
Yes
No
Do you plan to take your pet out supervised?
Yes
No
If so which one?
On a leash On the porch In the backyard
Is the yard fenced?
Yes
No
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If you move what will happen to the pet?
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When you go on vacation who will be taking care of the pet?
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| Please be sure and give all your current Vet information below, if you don't have a vet LIST your last vet used and how long ago that was, we need this information and will verify it. |
May we contact your Vet? Yes
No
Current Vet's Name:
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No Current Vet, Give Previous Vets Name:
Used How Long Ago:
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| Vet's Phone:
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Vet's Address:
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May we make periodically visits to your home to see the pet?
Yes
No
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If your pet gets ill what will you do? |
Comment box for additional pertinent information:
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"If one of our Adopted Animals is being abused, neglected, not getting proper medications or vet care HART (Homeless Animal Rescue Team) Inc. - of New Jersey has the legal right to reclaim the pet. Any violations of our aggreement may/will result in the Animal being picked up and returned to Us with no return of adoption fees and, with no liability on our part for medical bills or any other expenses you may have incurred. If legal action must be taken to reclaim the pet all court costs will be the adoptees expense and responsibility. If for some reason you can no longer keep the Pet - it must be returned to us or adopted into a new home with our written approval."
This information will be printed right on your signed application. This is a legal, binding document and will be used in a court of law if necessary (at your expense).
*You must check that you have read and agree to this contract (contract will not be processed without your agreement)
*Yes - I fully understand and agree to ALL the terms of this legal document.
*No - I do not agree to ALL the terms of this legal document (your application will not be processed if you answer no to this question). |
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Signature*:
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| After you click Submit Form (only once please), you will be taken to a copy of your form, please check it to be sure it's OK, if not email us with the correct info. Thanks :) |
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*** In the event that your new Pet does not work out for you and your family, the Pet must be returned to the HART. Filling out an application does not guarantee a Pet to anyone. We have the right to refuse any application without an explanation. Filling out and sending in this form signifies that the above information is correct and you have read and agree with our rules. *** |
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For Office Use Only |
Received On:
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Initialed by:
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