HEAVENLY ANGELS ANIMAL RESCUE INC.

97 14 Liberty Avenue Ozone Park, NY 11417 (347) 722 5939

http://www.petfinder.com/member-pages/NY1047

~~~~~~~~ADOPTION APPLICATION~~~~~~~
Our goal is to place our homeless rescues in permanent loving homes, as their former owners have already abandoned them at least once before. As we strive to place the appropriate pet in the right home, this application helps us to learn more about you, your home and your level of experience, if any, with dogs/cats. Please e-mail this application after you have filled it out and send it back to: harescue1@aol.com to ensure fastest review by our adoption representatives ALL OUR RESCUES ARE SPAYED/NEUTERED PRIOR TO ADOPTION.

Please fill out ALL questions. If any question does not apply, write N/A.
Date: ________________________ Which pet are you interested in? ________________ Are you interested in Adopting or Fostering? __________________ How did you hear about us? ___ ____

__ ________

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PERSONAL INFORMATION~~
1. Full Name: ____ Birthday: Email (please print clearly): ____ Street: ____ City __________________________________ State __________________ Zip code: Day/Work Phone: ( ) _______ Evening/Home Phone: ( ) ____ Cell Phone: ( ) _____ Best time to call: ____

__________ ____ ____ ____

2. Please provide the contact information of a veterinarian you have used before. Vet references are checked. If you plan to use a different vet please list this vet also. Vet Name and Phone Number: ____ Vet records are under the name of: ____ New Vet you plan to use: ____ 2a. Please provide the names and phone numbers of two personal references I may call. (Neighbor, friend or co-worker):

REFERENCES~~

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#1: Name: #2: Name:

Number: Number:

Relationship Relationship:

____ ____

2b. Who will care for your pets when you are on vacation? ________________ __________

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2c. Please list place of employment for yourself and your spouse. I do not call employers - this is simply for my records. SELF: Name/Address of Employer/Phone __________ ____ SPOUSE Name: Name/Address of Employer/Phone: ____ ________________

HOUSEHOLD INFORMATION~~ 3. Residence: rent apt - own apt own home other (specify)
____ a. How long have you lived here? ____ b. What floor do you live on? ____ c. Are you moving in the near future?

_______

___

Do you have a terrace? Please explain.

____ ____ d. If you rent, please provide your landlord's contact information so that I may verify that
you are allowed to have a pet. Landlord name, address & phone number:

__________________________________________________________________________ 4. Is everyone in the household aware of and agreeable to your interest in fostering/ adopting? ____ 5. Does anyone in your house have asthma or any known allergies to dogs or cats? ____ 6. Please list below all people who currently live at this residence (including yourself).
(Please include name, relation to you, and age.) Name: Relationship: __________ Name: Relationship: ____ Name: Relationship: ____ Name: Relationship: ____ Age: Age: Age: Age: _ _ _

7. Please list below any cats, dogs, etc. who currently reside in your household.
(Please include Name, Kept where?) Name: Kept?____ Name: Kept?____ Name: Kept?____ Breed: Breed: Breed: Age: Age: Age: Sex: Sex: Sex:

Type/Breed, Age, Sex, Altered or not? How long owned? Altered? How Long? Altered? How Long? Altered? How Long?

HISTORY~~ Page 3 of 8

8. Please complete this regarding any other pet you have owned in the past. Include
name, type/breed, age, how long owned, what happened to pet. Name: Breed: Now?__________ Name: Breed: Now?__________ Name: Breed: Now?__________ Altered? Altered? Altered? Age: Age: Age: How Long? How Long? How Long? Where Where Where

9. Have you ever taken one of your pets to a shelter or given an animal away? If so,
please describe circumstances.

____ ____

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CARE OF THE DOG~~ (If adopting a Cat, skip this section)

10. Do you have a completely fenced in area on your property? ______________________________ Approx. how large is the fenced in area? Height and type of fencing? ______________ Can strangers gain access to your yard? Does the gate have a lock on it? ____ If so, what type? If you have a pool, is it fenced in? ____________________________ 11. Are there regular visitors to your home (human or animal) with which your new dog must get along? If yes, whom? __________ _____ __________ 12. If you have no fence, how do you plan to have your new dog relieve and exercise itself? ____ ____________________________ 13. What outdoor activities would include your dog? __________ __________ 14. Who will be responsible for the care of this dog? __________ 15. Do all adults work full time? __________ 16. How many hours each day will your new dog be alone? __________ 17. How many hours each day will you spend time with your dog? ________________ 18. Where will your new dog be kept when it is alone? ________________ 19. Where will your new dog be kept during the day? __________ 20. Where will your new dog sleep? _____________________ 21. Will the dog be allowed on the furniture? ____ If not, how do you plan to get the dog off the furniture if she/he does jump up there? ________________ __________ 22. Do you plan to rough-house (play rough) with this dog? __________ 23. Are you familiar with positive methods (no hitting) of dog training? ________________ 24. Do you want a trainer recommendation? __________

CARE OF THE CAT~~ (If adopting a Dog, skip this section)

25. Have you ever had a cat before? ____________________________ 26. Are you aware of the proper procedure to introduce a new cat/kitten to an existing cat?_________ 27. Will the cat(s) have outside access? ____________________________ 28. Are all your windows completely screened? __________ 29. Are you aware of the Dangers of allowing a cat outside? __________

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30. Do you travel with your cat? If Yes, Where ? ________________________________ 31. Do you have leather furniture and understand it may get scratched ___ __________ 32. Are you aware that most behavior issues (not using litter box, scratching, etc.) can be corrected? _________________________________________________________________________________ 33. What type of food do you prefer to feed the cat? Wet/Dry/Both ____________Brand? __________ 34. What would you do if your cat develops a medical condition that becomes costly? _____________ _________________________________________________________ 35. Do you believe declawing a cat is cruel? If Not, why?______________________________ 36. Are you aware that spaying/neutering provides many health benefits in keeping your cat healthy as well as correcting behavior issues? __________________________________________________ 37. What would you do if you were to date or marry someone who is allergic to cats? ________________________________________________________________________________________ 38. Cats frequently live to be 16 years or older. Do you believe you will be able to keep the cat for its full lifespan and if not, what provisions will be made for the cats future? ______________________

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ADOPTION FEES
The Animal Center of Queens is a private rescue facility dedicated to saving as many homeless pets as possible. We provide them with shelter, food, medical care, socialization and training of any behavior issues in order so they can be adopted into loving homes. Some will need continued training from you post-adoption. We pay all expenses and one sick animal can be a major financial burden. The center must also pay monthly rent, electric, heat, internet and phone, sanitation and other expenses in order to maintain the facility and keep our rescued animals safe until a home is found. There is an adoption fee for the Dogs and Cats that includes a pre-adoption general check-up by a vet, vaccinations, deworming, altering, microchipping and food. For older and harder to place animals, the regular fee is reduced. We also offer discounted dog obedience training for adopters and gladly welcome any post-adoption questions or issues that arise in order to achieve and maintain a successful lifetime adoption. Always contact us immediately by phone AND email of any emergencies. The foster/adoption procedure includes filling out this application, a phone interview, an appointment to meet the dog/cat in-person, contract signing (which stipulates the animal MUST be returned to us if you can no longer care for him/her), and home visit prior to fostering/adopting. This is all to ensure the safety of the pet since we dont know you. Is this acceptable? ________________ If no, why? ________________ Please realize that pets will need vet care while being fostered/adopted, including checkups, boosters or titer tests, heartworm and flea/tick preventative meds, etc. Adopting a pet is both a long-term and financial commitment - please consider this before adopting. If you are fostering a pet for us will ask that you help financially with the pets care. For any medical issues you must contact the Animal Center immediately and you Must use the centers vet as otherwise we cannot reimburse you for any medical bills. You must live in the Animal Centers local area to be considered as a foster parent unless prior arrangements are made. Are these terms acceptable to you? If so, please indicate by signing below: Print name: Date: __________ __________

THANK YOU FOR YOUR INTEREST IN HELPING OUR RESCUED PETS!!

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