Adoption Application

Adopter Information

Applicant *

First

Last

Age

Phone *

Email *

Occupation

Employer(s)

Do you have a spouse, partner or other person you would like to list on the application? *

Yes
No

Applicant #2 *

First

Last

Age

Phone

Email

Occupation

Employer(s)

Why do you want to own a Greyhound?

What pets have you had in the past? Why are they no longer with you?

Household Details

Address *

City *

State *

Zip *

Select your dwelling type

Do you rent or own? *

Rent
Own

Do you have a fenced in yard? (Invisible fences are not acceptable) *

Yes, I have a fenced in yard
No, I don't have a fenced in yard

What kind of fencing do you have installed? *

Are there stairs in your home that the dog will need to go up and down? *

Yes
No

Do you live with children or will children frequently visit your home? *

Yes
No

Number of Children *

Children's Ages *

Do you have any other pets currently (cats, dogs, caged animals, outside animals)? Describe below, please include type, age, sex (spayed or neutered).

Care Specifics

Are you willing and able to take the dog outside to relieve itself at least four to five times every day in all kinds of weather? *

Yes
No

Explain briefly how you feel about walking a dog on a leash at all times when outside and not in a completely fenced in area.

Do you promise to keep a collar, bearing identification, on the dog at all times, and further promise to notify Heartland Greyhound Adoption immediately if the dog should ever become lost? *

Yes
No

Do you understand that greyhounds cannot be chained and left outside? *

Yes
No

Are you fully aware of the fact that this dog's career as a racer is over, and that you will be unable to re-activate that career? *

Yes
No

Have you carefully thought about your willingness and ability to financially care for your greyhound should it develop 'special needs' and require medical attention beyond the regular and routine health checkups, shots, and annual dental cleaning? *

Yes
No

Are you prepared to include your greyhound in your home as a family member by providing a soft, cushioned bed on which it can rest; an elevated dish where it can eat and drink; a crate for security when you're away; a warm coat for the greyhound to wear in cold weather; a few toys for it to play with; and a soft, gentle voice and hand to earn the greyhound's love and devotion? *

Yes
No

Are you prepared to obtain one of the two books recommended by Heartland Greyhound Adoption and to have read it prior to placement of your greyhound?

Yes
No

Veterinarian Information

Have you already selected, or are currently using a veterinarian? *

Yes
No

Name *

Phone *

Address

City

State

Zip Code

You agree that this is a contract between you and Heartland Greyhound Adoption, and, as such, is binding. Do you agree to notify Heartland Greyhound Adoption if, for any reason, you find that you cannot keep your dog, and further agree that you will not give or sell the dog to anyone else without Heartland Greyhound Adoption's expressed and written consent? *

I Agree

You agree that Heartland Greyhound Adoption reserves the right at any point during the interview process, to deny an adoption if our required conditions are not met or information supplied is falsified. *

I Agree

Personal Reference

Name *

Phone *

Address

City

State

Zip

Would you like to add a second reference? *

Yes
No

Personal Reference #2

Name *

Phone *

Address

City

State

Zip Code

Do you understand that your ownership of this dog will be subject to the conditions set forth in this application, and that if the dog is judged to be kept in an unacceptable fashion by Heartland Greyhound Adoption, Heartland Greyhound Adoption is entitled to regain ownership of the dog? *

I Understand

Do you have any additional information or comments you would like to share with us regarding your applicaiton?

Yes
No

Comments or additional information

Would you like to pay your application fee now via PayPal? *

Yes
No

Application Fee

Price: $ 30.00