Thank you for considering adopting one of our fantastic pets... To start the process, you can
begin by completing the application below. Though it may seem a little lengthy, it is our
mission to seek out the best possible homes so they never are abandoned or surrendered to
a kill shelter again.
Once you complete the application you should receive a reply within 3 days. If you do not
simply send us a reminder.
Hope Rescues Adoption Application

3701 Coronado Dr
Alton, IL  62002
Phone:  (618) 463-9983
Cell 1 : 618-979-1908
Cell 2:  (636) 212-0363
Date (mm/dd/yyyy) :
Name and/or breed of the Pet  you are interested in (if known):
Driver License Number :
Applicant's Name:
Present Street Address:
City:
 State:
 Zip:
How long at this address?
Are you planning to move in the near future ?
If yes,  what will you do with your pet(s) ?
Home Phone Number:
Cell Phone Number:
Work Phone Number:
E-mail Address:
Are you over 18 years of Age ?
Occupation:
How long are you away from home each day ?
hrs
Your Current Home Environment
Do You Rent or Own ?
Type of Home you currently live in:
The following questions only apply if you do not own your own home:
  • Name of apartment complex, mobile home park or landlord (if applicable):
  • Are Pets Allowed ?
  • Please list pet restrictions, if any (i.e., weight, number of pets allowed, etc.
Do you have a fenced yard ?
The following questions only apply if you have a fence
  • Type of fence:
  • Fence Height:
 Ft.
Members Within Your Household
How many Adults live in your home ?
How many children live in your home ?
List Ages:
Do any members of your household have allergies ?
Information of Current Pets:
Please list all of the pets currently in your
household ( include any pets belonging to
roommates:

Be sure to include the following:
Type of Pet (dog, cat, ferret, etc.)
Breed
Male or Female
Age of Pet
Are any of these pets kept outdoors ?
Are all of your pets spayed or neutered ?
  • If you answered "No", which pets are not spayed / neutered ?
Veterinarian Information:
Veterinarian's Name:
Vet's Address:
Vet's Phone Number:
Pet History:
Have you had any other pets in the last five years that are
not listed on this application?
If yes, list  the Type of Animal, Sex, Age, Spayed /
Neutered (Y/N) and what happened to it
Have you adopted any pets from a rescue group or animal shelter in the past?
If yes:

Which rescue group(s) and/or
shelters?
Where is this pet now?
Pet Specifics:
What gender of dog are you interested in adopting?
What age pet are you interested in adopting?
If a dog, What size dog are you interested in adopting?
How active would you like your pet  to be?
I want this pet for: :
While holding
your Ctrl button
pick all that
apply
How long have you been looking for a pet?
My pet will be kept:
If your pet is left outdoors, what type of shelter will be provided?
Will you be using a tie-out or chain to secure the dog?
When your pet is left by itself, the pet will stay:
Where will your pet sleep at night?
How long will your pet be left by itself during the daytime?
If you live on acreage in the country, how will you
keep your pet confined to your property?
Care and Training of your Pet
Who will be responsible for the socialization,
medical care and training of this pet?
Would you be interested in attending training sessions?
Who will be responsible for housetraining this pet?
Are you interested in information on housetraining?
Are you interested in information on obedience training?
There are times when unexpected and often very expensive
medical conditions occur. Are you committed to providing
whatever medical care your veterinarian deems necessary
for your pet ?
List your personal reasons for wanting a pet:  
Are you willing to allow a representative of our group visit your residence?
Use this space if you have any additional
comments:
Please enter your initials in the space provided after each statement
I/we, the undersigned adopting party, understand and agree to the following terms and
conditions of this contract in the acquisition of the above-described animal , hereinafter
referred to as "pet":
1. To return the pet  to the Rescue Program if unable to keep the
pet. To never abandon the  pet or surrender, sell, or give the pet  
to a shelter, pet dealer, or a laboratory.
2. To notify the Rescue Program if the pet  is lost or stolen and to
make all reasonable efforts to locate the pet.
3. To never allow this pet to be trained for or used for protection or
as an attack pet.
4. To treat this pet as a family pet with affection and kindness,
never subjecting this pet  to abuse or cruelty.
5. To provide regular veterinary care, including annual shots,
heartworm preventative, and parasite checks.
6. To always keep this pet within a fenced yard - not on a chain, or
a leash (unless being walked), or safely within the home.
7. To never transport this pet unconfined in an open vehicle such
as the bed of a truck or open jeep.
8. To regularly check the tightness of any collar. To affix any
licenses and tags to the collar and to never leave a choke chain on
the pet when not attended.  the Adopter(s) shall comply with all
state / local ordinances regarding pet licensing, identification and
restraint.
9. To notify the Rescue Program of the pet's annual progress
10.  To notify the Rescue Program if I / we move
11. To allow the Rescue Program to periodically check on this pet.