Adoption Application Adoption ApplicationΔRequirements of Adoption:All Dogs/Cats in your home must be up to date on vaccinations, on heartworm preventative and spayed/neutered. Some exceptions may apply. If any information is not provided as asked on this application, this may be grounds for refusal.Thank you for submitting an application to adopt a pet from Hart County Animal Rescue. Please know we work hard to respond to applicants. Our goal is to review each application as thoroughly and timely as possible - we contact vets for references, we do Facebook searches and we use google maps to verify addresses and fencing. We have criteria we require and look for the most suitable match. Please allow up to 7-10 business days for our team to review your application.First NameLast NameAddressAddress Line 1Address Line 2CityStateZip CodeCountrySelect CountryAfghanistanAland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelauBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicDemocratic Republic of the Congo (Kinshasa)DenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyIvory CoastJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacao S.A.R., ChinaMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalestinian TerritoryPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRepublic of the Congo (Brazzaville)ReunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint Martin (Dutch part)Saint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia/Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited Kingdom (UK)United States (US)United States (US) Minor Outlying IslandsUnited States (US) Virgin IslandsUruguayUzbekistanVanuatuVaticanVenezuelaVietnamWallis and FutunaWestern SaharaYemenZambiaZimbabwePhone NumberEmailPhone NumberName of Pet you would like to adopt: Breed of Pet you would like to adopt:What would you like to adopt? Dog CatHave you adopted from Hart County Animal Rescue before? Yes NoName of Pet AdoptedYear of AdoptionDo you own or rent your home? Own RentPlease provide the name of your landlord:We do check veterinary references. Please give us your vet’s name and phone number, and your current or previous pet’s name. We also need the name the vet records will be under. Failure to provide this requested information may delay or reject your application:How many people live in your home?Do children live in your home? Yes NoPlease list the ages of the children in your home.Do you have a Facebook account? Yes NoFacebook ProfileDescribe pet’s living quarters:How many hours a day will your pet be left alone?Do you have other animals living at your home? Yes NoPlease describe the other pets living in your home.Do you have a securely, fully enclosed fenced yard? Yes NoWhat type fence? Privacy fence Chain link fence Underground/electric OtherPlease describe your fence.Do you have an outdoor kennel? Yes NoHow will you exercise your dog?Have you ever re-homed or surrendered a pet to shelter? Yes NoPlease explain the situation.Would you allow our staff to conduct a home visit prior to adoption? Yes NoWhat monthly flea/tick preventative do you use?What monthly heart worm preventative do you use?Are you financially prepared to take care of this pet for routine veterinary care, food and shelter? Yes NoHow did you hear about this available Pet? Facebook Petfinder Our website OtherWhere did you hear about the pet?I certify that the information on this application is accurate. I understand that withholding information or giving false information will result in a refusal to adopt or having an adopted pet taken back at any time. I certify and agree.I will provide adequate veterinary care for the pet I adopt, including annual rabies vaccinations, and other care recommended by my veterinarian. I agreeI will sign and abide by the adoption contract. I will accept the terms and condition of the adoption and verify that all information entered is true and correct. I agreeAre you 18 years or older? Yes NoPlease type your name as signature to this adoption application.Submit Form