Hounds of the Heartland
Greyhound Pets of America / Central Oklahoma
Greyhound Adoption Application
Applicant Name:		Applicant Age:	Select Under 21 21-25 26-40 41-60 Over 60
Applicant Address:
City:		State:	AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VI VA WA WV WI WY
Zip:		Phone:
Email Address:
Employer:		Work Phone:
Co-Applicant Name:		Co-Applicant Age:	Select Under 21 21-25 26-40 41-60 Over 60
Co-Applicant Address:
City:		State:	AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VI VA WA WV WI WY
Zip:		Phone:
Co-Applicant Email:
Co-Applicant Employer:		Work Phone:
Non-adult children's names and ages:
Number of adults in household and hours they are home:
How many hours per day will your greyhound be alone?			0 1 2 3 4 5 6 7 8 9 10 Over 10
Where will your greyhound stay during the day?
Who will have primary responsibility for the care of your greyhound?
How long have you considered this decision?
Have you read our required reading "Adopting the Racing Greyhound" or "Retired Racing Greyhounds for Dummies"?			No Yes
If you have children, have you read our required reading "Childproofing Your Dog"?			N/A No Yes
Are all members of the household in total agreement with this adoption decision?			No Yes
How did you hear about GPA?
Why do you want to adopt a greyhound?
Do you intend to obedience train your greyhound?			No Yes
Do you intend to jog/run with your greyhound?			No Yes
Names, species, gender, and age of pets you currently own:
Do you have any outside dogs?			N/A No Yes
Do any of your cats go outside?			N/A No Yes
Veterinarian's name and phone number where your current pet's medical history and current vaccinations are on file:
How long have you used this veterinarian?
Are your pets current on vaccinations?			N/A No Yes
Do you know what heartworm preventative is?			No Yes
Use currently?	N/A No Yes	What Brand?
Are your pets spayed/neutered?			N/A No Yes
List all pets you have owned as an adult:
What happened to them and at what age?
Please list two (2) personal references (not related to you) with home and/or cell phone numbers:
Does HoH/GPA have your permission to call your veterinarian(s) and personal references?			No Yes
Would you be willing to have a HoH/GPA representative visit your home?			No Yes
Will your greyhound be kept as an indoor pet and not left outside, in the garage or confined to a room?			No Yes
Will you purchase and use a kennel/crate for your greyhound to stay in while you are away from home?			No Yes
Fenced in yard?	No Yes	Fence type:	N/A Chainlink Picket Privacy Ranch Woven Wrought Iron
Fence Height:	N/A 1 Foot 2 Feet 3 Feet 4 Feet 5 Feet 6 Feet Over 6 Feet
If no fence, is there a fenced in area nearby where you can exercise your greyhound 2 to 3 times per week?			N/A No Yes
Type of residence?	Select Apartment Condo Duplex Home Mobile Home	Do you:	Select Own Rent
How long have you lived there?
If you rent, are you allowed to have a dog weighing over 50 pounds?			N/A No Yes
Landlord's Name:		Landlord Phone:
Do you have a swimming pool, lake, pond, or river in or near your yard?			No Yes
Will you put a lock on your gate to ensure that the greyhound is not let out or let itself out?			N/A No Yes
Do you agree never to allow your greyhound to run loose?			No Yes
Greyhounds cannot be tied to any stationary object, as they are able to take off so quickly that they can literally break their necks.  Do you agree never to tie your greyhound out without your constant supervision?			No Yes
Will you notify HoH/GPA immediately if your greyhound is ever lost or stolen?			No Yes
Do you agree to return your greyhound to HoH/GPA if for any reason you are unable to keep him/her?			No Yes
Do you agree never to transfer ownership of your greyhound to anyone without the consent of HoH\GPA?			No Yes
Will you keep your greyhound on heartworm preventative every month and continue annual vaccinations?			No Yes
Do you agree to keep an ID tag (yours and HoH\GPA's) on your greyhound at all times?			No Yes
THE FOLLOWING QUESTIONS WILL HELP US IN THE SELECTION OF YOUR NEW GREYHOUND
Gender preference and why?
Our retired athletes are between the ages of 2 and 9, and weight between 60 and 85 pounds.  Can you be flexible with regards to age and size?			No Yes
If the gender, color, size, and age you desire is not available, will you consider another greyhound?			No Yes
Would you consider one of our special needs greyhounds?  This usually means special medical needs, special food, allergies, older age, very shy, etc.  Please answer with why.
What children or animals will your greyhound be in contact with that do not reside with you?
Please provide us with any additional information that may help us in the selection of your greyhound:
HoH/GPA reserves the right to refuse the adoption of one of our greyhounds to anyone for any reason. I hereby certify that the information given in this Greyhound Adoption Application is true and correct.  Upon adoption, I accept full responsibility for the welfare and care of the greyhound, releasing the greyhound's previous owner as well as HoH\GPA and its representatives from any future liability concerning the greyhound.  I understand that HoH\GPA reserves the right to repossess any greyhound for violation of the adoption contract or if the greyhound should be mistreated. Please type your full name as a digital signature.
Signature:		Date:
Co-Applicant Signature:		Date:
Both signatures required if applicable