Adoption Application

We appreciate your interest in adopting a HALT graduate. Applications are now being accepted for our Fall 2016 class. In order to provide our HALT dogs the best possible home environment, we ask you to complete this adoption application. HALT’s Adoption Committee will review the application and complete veterinary and reference checks, home visits, and interviews. Please note dogs are not able to go to their new homes permanently until completion of the HALT classes. Please fill out all fields and submit the application below.

H.A.L.T. serves Knoxville, TN, Oak Ridge, TN and immediate surrounding counties. Because of our home visit policy we are unable to do adoptions outside of our area at this time.

All Fields are required

Your Name

Address

City

State

Phone Number

Your Email (required)

Would you like to receive email updates about HALT?

What is your preferred method of contact for the adoption process?

PhoneEmail

Which dog(s) are you interested in?

Please list two personal references, their relation to you (family, friend, co-worker, etc) and their phone numbers:
Reference One Name:
Reference One Relation:
Reference One Phone:
Reference Two Name:
Reference Two Relation:
Reference Two Phone:

Do you live in a:
houseapartmentother
If other:

Do you:
ownrent

If renting, does your rental agreement allow pets?
yesno

Landlord/rental agent name:

Landlord/rental agent phone:

Do you have a fenced yard?
chainlinkwoodinvisible fenceotherno fence

Do you have a pool?
yesno

Would you agree to a home visit conducted by HALT?

Why do you want a dog?

What kinds of activities do you plan to participate in with your pet?
obedienceagilityhikingcampingwalkstravelsnugglingcompanion to current petplaying with kidsother

Would you consider a special-needs dog such as one who requires medication for a permanent but controlled condition?
yesno

Have you had a pet previously?
yesno

If so, what happened to your pet?

Do you have any pets now?
yesno

If so, please tell us more about them here:

If you currently have pets, has your current pet(s) ever been around other animals?
yesno

If so, list them here:

Do your current pets have any special characteristics of which we should be aware?
yesno
If so, list them here:

Are your current pets spayed/neutered? (or were past pets?)
yesno

Are your pets on heartworm preventive? (or were past pets?)
yesno

Are your pets micro-chipped? (or were past pets?)
yesno

What is your current veterinary clinic or what was your veterinary clinic for past pets, and in what city/state?

May we call your veterinarian for a reference?
yesno

Are there any kids living in your home or that frequently visit your home?
yesno

What are their ages?

Does anyone in your home have pet allergies?
yesno

Where will your dog be during the day?

At night?

How long will your dog be alone daily?

When you travel, who will care for your pet?

If you move, what will happen to your pet?

What are your greatest concerns in getting a new pet?

For what reason(s) would you consider returning your new pet?

Would you be willing to attend additional obedience classes?
yesno

Are you aware of any other resources to you if any problems arise?

If you adopt from HALT and decide to give up the dog, do you agree to contact HALT to see if we can offer additional resources or help find a new home for it?
yesno

Have you applied to any other rescue groups?
yesno

If so, please identify the group(s) so that we do not duplicate their efforts.

How did you hear about HALT?

Would you be interested in volunteering with HALT?
yesno

Would you be interested in being interviewed on behalf of HALT?
yesno

Please note any additional comments, questions, or concerns.

By submitting this form, you agree the information is complete and accurate.