Siberian Husky Adoption Application

Which dog(s) are you interested in?*
About You
Please be as detailed as possible in all answers - the more detail, the greater likelihood your application will result in a successful placement and adoption.
Name*
First Last
Phone*
Email*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
What is your employment situation? Work full time, retired, etc.*
Do you foresee any major life changes over the next two years? (promotion, work transfer, moving, marriage, having children, etc) If so, how will you work through this with your pet should there be any issues?*

About Your Home
Please be as detailed as possible in all answers - the more detail, the greater likelihood your application will result in a successful placement and adoption.
Please list all current pets (including dogs, cats, birds, small animals, livestock, etc) in your household:*
Species & Breed Gender Age Fixed? Temperament

(Use the (+) symbol to add more rows for more pets - enter n/a if not applicable)
Can you provide vaccines/spay/neuter certificate upon request for any current pets??*
- Yes
- No
- n/a
Please list all pets from the last 10yrs, both those who have passed as well as who are no longer residing with you?
Species & Breed Gender Fixed? Special medical needs? Passed away or rehomed?

(Use the (+) symbol to add more rows for more pets)
For animals no longer in your home as a result of rehoming, please explain why the pet needed to be rehomed - this is not an automatic disqualification as we understand all circumstances are different.
Please list all people in your household INCLUDING CHILDREN as well as your relationship to them, and their commitment to the new pet - 0 indicates they do not want a dog, 1 indicates they are OK with a dog but don't want to be involved in care, and 5 indicates excited and motivated to provide the best care for the dog.*
Name Relationship (or self) Age Commitment

(Use the (+) symbol to add more rows for more pets)
If you have a roommate, how do you plan for them to be involved in the dog's care?*
Does anyone have an allergy to animals?*
- Yes
- No
If so what kind? (enter n/a if not applicable)*
How many hours will the dog be alone per day?*
Where will you keep the dog when not home?*
Where will your new dog spend its time?*
- Indoor
- Outdoor
- Indoor/Outdoor
Do you have a doggie door?*
- Yes
- No
Do you rent or own your home?*
- Rent
- Own
Landlord Name & Phone - enter n/a if yourself.*
( If you rent, we will need a letter from your landlord stating you can have a dog.)
Is your yard fenced?*
- Yes
- No
Material and Height of Fence*
Do you have a pool?*
- Yes
- No
If yes, is it fenced?
- Yes
- No
How many children, and how old are they?*

Background
Be as detailed as possible.
Have you ever lived with a dog from a rescue organization or shelter? If so please specify rescue and circumstance.*
Have you ever purchased a dog from a breeder? If so, please describe your interest in now rescuing?*
Do you understand how the dog rescue process works? If not, we are happy to answer questions - please be as specific as possible.*
Are you willing to take responsibility for this pet for the next 10–15 years?*
- Yes
- No
What amount of medical care would you consider reasonable/necessary for your adopted dog?*
Routine Care (amount in dollars yearly for non-emergency care) Emergency life-saving medical
What do you consider to be needed for a dog's annual medical care?*
Have you ever had a dog with a medical emergency, or a longterm illness? If so, please specify and describe how you treated the condition, what the cost was, and what the outcome was?*
In terms of a treatable medical emergency, how much would you be able and willing to spend to save a dog's life?*
- Up to $100
- Up to $500
- Up to $1000
- Up to $5000
- No Limit
Acknowledgement
I acknowledge that all the above information is true and correct to the best of my knowledge.
I understand that any misrepresentations of fact may result in removal of the adopted dog from my home by AZ Husky Rescue. Upon approval and placement, a signed copy of the above information will be required for verification.
Home Visits
I understand that a representative from AZ Husky Rescue will make an initial home check to verify the above information is accurate. A signed adoption contract must be filled out before dog officially becomes yours! Foster will get this form from you to verify adoption.

So you’re ready to adopt?

Adopters must have a 6ft+ fence. We prefer to adopt to those in houses, but make exceptions for apartments and condos on a case by case basis considering the dog and owner’s respective energy levels.

Fill out the form to the right, or email us the completed form.

Dog Adoption Interest Form

Step 1 of 4

About You

About Your Home

About the Dog

Background

Acknowledgement

Home Visits

About Us

Contact Info

Species & Breed	Gender	Age	Fixed?	Temperament

Species & Breed	Gender	Fixed?	Special medical needs?	Passed away or rehomed?

Name	Relationship (or self)	Age	Commitment

Routine Care (amount in dollars yearly for non-emergency care)	Emergency life-saving medical