Name:
Email Address:
Address:
City:
State:
Zip:
Home Telephone:
Work Telephone:
Best Time To Contact:
Occupation:
Employer:
Number of Adults Living In The Home:
Ages of Adults Living In The Home:
Hours An Adult Is At Home:
Number of Children Living In The Home:
Ages of Children Living In The Home:
Does anyone suffer from pet related allergies? (explain)
Is there a pool, lake, pond, river, etc. near your yard? (explain)
May we inspect your premises?
Yes:
Describe type of home you have?
Are there stairs in your home? (explain)
Describe the type of backyard fencing you have (Include height)?
Please specify if you OWN or RENT your home
Own:
If you are RENTING, please answer the following 9 questions. If not, please skip.
Is there a pet deposit required? (explain)
Is there a pet size or weight limit? (explain)
Can we obtain a pet permission statement from your landlord?
Yes:
Landlord's Name
Landlord's Address
Landlord's City
Landlord's State
Landlord's Zip
Landlord's Phone
What Greyhound characteristics do you desire? (explain)
Will you accept substitutions? (explain)
Why do you want to adopt a Greyhound? (explain)
How did you learn about Greyhounds of Shamrock and Greyhounds for adoption? (explain)
Where will the Greyhound live in your home? (explain)
In the past 12mos have you applied to another Greyhound agency? If so, which one?
Explain your feelings about leaving, chaining or tying a dog outdoors?
Explain your feeling about having a Greyhound on a leash at all times when not in a completely fenced area?
Are you willing and able to allow the Greyhound to relieve itself, 4-6 times daily?
Yes:
Will you keep a collar, license, rabies, id tag and Shamrock Greyhound id tag at all times on your Greyhound?
Yes:
Will you notify Shamrock Greyhound Placement immediately, if the Greyhound becomes lost?
Yes:
Will you notify and return the Greyhound to Shamrock Greyhound Placement if you no longer want or are able to care for the Greyhound for any reason?
Yes:
Do you promise not to give away or sell the Greyhound without written permission of Shamrock Greyhound Placement?
Yes:
Will you keep the Greyhound solely as a house pet and never use the Greyhound for racing, hunting or research experiments?
Yes:
Are you aware that the Greyhound's racing career is over and you will be unable to reactivate this career?
Yes:
Are you prepared and willing to make a non-refundable donation of $200 to Shamrock Greyhound Placement to defray its costs?
Yes:
I understand that a $50 deposit is required at the time of the homevisit. This deposit will be applied to the adoption fee at time of placement. If after the homevisit I choose not to adopt a Greyhound I understand that the money will be considered a donation & will be applied to the Shamrock Greyhound Placement General Fund. I understand that if my application is denied, the deposit will be returned to me.
Yes:
List all pets that you have had for the past 5 years:
Veterinarian's Name
Veterinarian's Address
Veterinarian's City
Veterinarian's State
Veterinarian's Zip
Veterinarian's Phone
Two Personal References (not living with applicant nor a family relation)
Reference's Name(1)
Reference's Relationship(1)
Reference's Telephone(1)
Reference's Name(2)
Reference's Relationship(2)
Reference's Telephone(2)
TYPE your initials here
Additional Comments
I hereby certify that all the information contained on the Greyhound Adoption Application is true and correct.
Upon completion of adopting a Greyhound, I agree that this Application will become a part of the Adoption Contract.
I understand that adoption of this Greyhound will be subject to the conditions set forth in this application.
If the Greyhound is judged to be kept in an unacceptable environment by Shamrock Foundation, Inc. is entitled to regain ownership of the Greyhound.
Shamrock Foundation, Inc Greyhounds arrive in their new home (spayed or neutered / DHP-Parvo inoculation / rabies injection / wormed / teeth cleaned / heartworm checked).
