Adopt A Husky Adopt A Husky, Inc.

 

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Adoption / Foster Application

Please complete all fields to the best of your ability.
Missing information may cause a delay in processing your application.

* indicates required information.
Note: we can only accept applications for those residing in the states in which we operate (IL, WI, MN, WA, OR, ID).

Personal Information
First Name *:
 Last Name *:
Driver's License Number:
 Age of applicant *:
Contact Information
Street Address *:
City *:
 State *:
 		 ZIP Code *:
Home Phone *:
 Best time to call:
Email address *:
Employment Information
Employer:
 Occupation:
Work Phone:
 Best time to call:
Personal References
Please list at least two references *.  Please list no more than one relative.
First Name Last Name Relationship Phone Number
Residence Information
Type of dwelling *:
 How long at this address?:
 Do You *:
Rent Own
Do you have the landlord's permission to keep a dog? Yes No
Landlord Information
First Name:
 Last Name:
 Company:
 Phone Number:
Do you have any future plans to move? Yes No
Containment Information
Do you currently have a fenced yard *? Yes No
If yes, please specify the height(s) (check all that apply):
Under 4 ft. 4 foot 5 foot 6 ft. or higher
and the type(s) (check all that apply):
Chain Link Privacy Invisible Other:
If you indicated you do not have a fence, how do you plan to handle exercise and toilet duties (please explain in detail)?
If you plan to install or change your fence, when do you plan to do so?
If you plan to install or change your fence, please specify the height(s) (check all that apply):
Under 4 ft. 4 foot 5 foot 6 ft. or higher
and the types(s) (check all that apply):
Chain Link Privacy Invisible Other:
Household Information
Please list the following information for each person, other than the applicant above, who will be living in the household with the dog (please list spouse or significant other first):
Name Age Relationship Occupation Employer
Who will be the primary caregiver for this dog?
Is everyone in the household aware of and agreeable to your interest in adopting? Yes No
Siberian Husky Knowledge
Please check all that apply:
I have owned a Siberian Husky.
I have done research on the Internet.
A family member owns a Siberian Husky.
I have talked to people who own Siberian Huskies.
I have read book(s).
I have read the AAHI description.
A friend owns a Siberian Husky.
Other:
Are you aware that Siberian Huskies shed, are known diggers and escape artists, and love to run? Yes No
Are you aware that the yearly maintenance of a dog is approximately $200-$300 (not including food or grooming)? Yes No
Feline Ownership
Have you ever owned any cats? Yes No
How many cats have you owned in the last 10 years?
Briefly describe what happened to the cat(s) you no longer have:
Do you currently own any cat(s)? Yes No
How many cat(s) do you currently own?
Are they indoor or outdoor cat(s)?
Please enter any additional comments regarding your cat(s) here:
Canine Ownership
Have you ever owned any dogs? Yes No
How many dogs have you owned in the last 10 years?
Briefly describe what happened to the dog(s) you no longer have:
Do you currently own any dog(s)? Yes No
How many dogs do you currently own?
Please indicate the following for each dog:
Name Sex Age Breed Spayed/Neutered

Yes No

Yes No

Yes No

Yes No
Please enter any additional comments regarding your dog(s) here:
Other Pet Information
Do you currently own any pets other than dogs or cats? Yes No
Please indicate the following for each pet:
Name Type Age
Additional Pet Information
Have you ever lost, surrendered to a shelter/rescue, placed in another home, or given a pet away? Yes No
If yes, why?
Do any of your pets have characteristics that Adopt A Husky should be aware of?
Veterinarian & Medical Information
Please provide the veterinarian who can confirm vaccination and heartworm testing records of your current pet.  If you do not currently have a pet, please provide a veterinarian who cared for a pet within the last five years:
First Name:
 Last Name:
Clinic:
City:
 State:
 		 Phone:
Is this the vet you currently use? Yes No
If this is not your current vet, please explain:
Adoption Information
Why have you chosen a Siberian Husky?
Are you willing to obtain a crate and crate-train your dog if necessary?
Yes No
If not, why?
Are you willing to take your dog to a basic obedience class? Yes No
If not, why?
Do you have the time to housetrain a dog? Yes No
If not, why?
What would you do if your dog bit somebody?
Do you have a Siberian Husky preference?
(rescue Siberians usually range in age from 1 to 8 years old)
Sex: Age: Color:
Would you consider a husky mix? Yes No
Please indicate what, if any, specific personality traits you are seeking in your new dog:
The New Dog
Where will the new dog spend the day (check all that apply)?
Loose indoors
Crate
Basement		 Garage
Loose outdoors
Tied up outdoors		 Outside kennel run
Other:
Where will the new dog spend the night (check all that apply)?
Loose indoors
Crate
Basement		 Garage
Loose outdoors
Tied up outdoors		 Outside kennel run
In bed with owner
Other:
How many hours per day, on average, will the dog spend alone?
Is someone home during the day? Yes No
What are your work hours?
Who will care for your dog when you are on vacation?
Other Information
Do you agree to allow a representative of Adopt A Husky, Inc., to visit your home by appointment *? Yes No
How did you hear about Adopt A Husky?
Please let us know any other information which you wish us to consider in evaluating your application (if you are applying to FOSTER - please note that here):

We reserve the right to refuse or deny any application.  By clicking the Submit Application button below, you attest that all the information contained in this application is complete and truthful.  Any misrepresentation will constitute grounds for automatic rejection.

Please do not click the Submit Application button more than once.  You will receive a confirming response that your application has been processed.

     
Revised: Aug 2, 2007