Application

General & Contact Info

Adoption Application Form

General & Contact Info

Pet Name Interested In? (or unknown)*

Type of animal*

Dog

Cat

Other

How did you find out about OSPCA’s Adoption Program?*

First Name*

Last Name*

Your Birth Date*

Spouse / Partner First Name

Spouse / Partner Last Name

Home Address*

City*

State*

ZIP Code*

Primary Phone*

Secondary Phone

Email*

Confirm Email*

Driver’s License Number and State of Issue

Please Provide One Personal Reference*

Home & Lifestyle Info

Adoption Application Form

Home & Lifestyle Info

Now please tell us about your current living environment as it applies to a new animal family member.

What kind of a home do you have?*

Farm House

City House

Suburb House

Apartment

Mobile Home

Other

Do You Rent or Own?*

Rent

Own

Live with Relative

Other

How Long Have You Lived at This Address?*

Do You Plan On Moving Soon? If you are planning to move, please enter how many months or years from now.*

No, I do not have moving plans

Other

Does Your Rental Or Home Have Animal Type or Breed Restrictions?*

Yes

Do You Live In Military Privatized Housing?*

Yes

Other

Are there elderly people living in your home?*

Yes

Other

Number of children in the home? What are their ages?*

Employment Info

Adoption Application Form

Employment Info

Everyone must complete this information, including military.

What is your employment status?*

Full time

Part time

Not Employed

Other

What is your title or position?

How long have you had this employment status?*

Are you a member of the Armed Forces? If yes, please list the name and phone number of your Commanding Officer*

Pet History & Experience

Adoption Application Form

Pet History, Experience

How many animals live in your home?

Please list all current and past pets. (Click to expand)

Current and past pet # 1

Type / Breed

Age of Pet

Number of Years Owned

If no longer own, explain why

Spayed / Neutered?

Yes

Do you still own this pet?

Yes

Other Info?

Current and past pet # 2

Type / Breed

Age of Pet

Number of Years Owned

If no longer own, explain why

Spayed / Neutered?

Yes

Do you still own this pet?

Yes

Other Info?

Current and past pet # 3

Type / Breed

Age of Pet

Number of Years Owned

If no longer own, explain why

Spayed / Neutered?

Yes

Do you still own this pet?

Yes

Other Info?

Current and past pet # 4

Type / Breed

Age of Pet

Number of Years Owned

If no longer own, explain why

Spayed / Neutered?

Yes

Do you still own this pet?

Yes

Other Info?

Current and past pet # 5

Type / Breed

Age of Pet

Number of Years Owned

If no longer own, explain why

Spayed / Neutered?

Yes

Do you still own this pet?

Yes

Other Info?

Do your current personal pets get along well with other animals?

Are all your pets current on vaccinations? (if applicable):

Yes

Other

Please list any special training or experience that you have with animals/ pets

What is the name and phone number of your Veterinarian (if applicable)?

Have you adopted from Oahu SPCA before?*

Cat(s)

Dog(s)

Approximately when did you adopt?

Does any member of household have an allergy to animals?*

Yes

I don't know

Other

What will you do if you discovered someone in your home has or develops a pet allergy?*

Where will your pet primarily live?*

Indoors

Outdoors

Other

Where will the pet be housed when left alone?*

What would cause you to return or rehome this animal?*

How much are you willing to spend over the span of the animal’s lifetime? (Food, boarding, medical care, toys, training, etc.)*

$100

$500

$1000

Whatever it takes

What would you do if your vet bills are over this amount?*

If you move at any time while owning this animal, what you would do with the animal?*

Will the animal spend any time in the garage?*

Yes

Please explain when and why the dog would be in the garage

Do you have a pet door that leads outside?*

Yes

Where does this pet door lead to?

Where will your new pet sleep?*

If you currently have pets, what will you do to introduce the new animal to your home? (Do you anticipate them adjusting well? Why or why not?)*

If adopting a puppy, are you willing to keep him/her inside until all vaccinations are given? If no, please explain.

Are there times when your adopted dog will be tied up? If yes, please explain

Will you ever allow your adopted dog to ride in the back of a pick up truck? If yes, please explain

Do you have a yard? If yes, what is the approximate size? (20×60 As an example) Is it fenced?

If you have a yard, is it fenced? What type of fence, how high is the fence?

If you have a yard but do not have a fence, how will you keep your dog in the yard?

How much exercise will the dog get per day? What type of exercise will it be?

What are your thoughts on declawing cats?

Will you allow your cat to go outdoors unattended? Please explain.

Please list any concerns or questions you have about adoption so we can discuss them with you*

Agreements

Adoption Application Form

Agreements

I certify that this information is true. I understand that giving false information on this application is grounds for denying my application. I understand this application remains the property of the Oahu SPCA. This a legally binding agreement between Oahu SPCA and the Adoptive Parents for the purpose of protecting the rights of our animals and providing them with a proper home with the approved Adoptive Parent.

Traditional Adoption

This level agrees to adopt the animal and you will be the adoptive parent the moment you leave the premises with the animal. You will be assuming all responsibility for the care and wellbeing of the animal immediately, the microchip information will be transferred and the adoption will be finalized.

Foster-To-Adopt

This level gives you the chance to foster an animal in your home with the intent of adopting him/her. This period is for one (1) week, because by then you will know if he/she will fit into your home and lifestyle. During which time you will assume the responsibility for the care and wellbeing of the animal but you are able to return the animal within 1 week with a full refund of adoption fees. The microchip information will not be changed into the Adoptive Parent’s name until foster period has ended and adoption has been finalized.

Please check each box indicating your understanding and acceptance of the following. Both types of adoption, “Traditional” and “Foster to adopt” must agree to the terms below.

Agreement 1

I agree to comply with all local and state laws and ordinances relating to the care of domestic animals, and will not engage in any illegal activity with my foster animal.

Agreement 2

I agree to provide shelter, fresh water, wholesome food, adequate exercise and loving attention to the animal.

Agreement 3

I agree to never leave the animal in a car for an extended period of time, and never in warm weather for any amount of time without air conditioning.

Agreement 4

I understand that no animal is to ride in the back of a pickup truck.

Agreement 5

I understand that there are no guarantees of the behavior health or disposition of any shelter animals.

Agreement 6

I will promote positive reinforcement training and never do anything to harm or injure the pet regardless of behavior.

Agreement 7

I agree to keep all Oahu SPCA ID tags and microchip information on the animal. If adopting I agree to register the pet’s microchip with my updated contact info immediately after adopting.

Agreement 8

I understand that the shelter environment is very stressful and may take time to adjust to new situations, people and other animals.

9. ADOPTION FEE

I agree to pay the adoption fee in full at time of adoption. For a traditional adoption: if the animal is returned withing 48 hours of adoption, a refund will be at the discretion of the Executive Director. For the foster to adopt option: The fee is held as a deposit and will be fully refunded if the animal is returned within one week. OTHERWISE, ALL ADOPTION FEES ARE NONREFUNDABLE.

10. TERMINATION – ADOPTION

If the adoptive parent is unable to care for an animal adopted from Oahu SPCA, he/she will make arrangements with Oahu SPCA to arrange for return to the shelter. The adoptive parent will not give the animal to another person or entity without prior approval from Oahu SPCA.

11. RELEASE

The adoptive parents and his/her spouse, heirs, executors, personal representatives and agrees never to bring a claim or suit against Oahu SPCA. The adoptive parent releases Oahu SPCA and its directors, founders, employees, officers, agents, representatives, contractors, volunteers and successors and assigns from any liability to the adoptive parent and his/her spouse, hers, executors and assigns with respect to bodily injury, personal injury, illness, amputation, scarring, death, property damage or other loss that may result from the behavior or activities of the adoptive animal.

12. INDEMNITY AGREEMENT

The adoptive parent and his/her spouse, hiers, executors, personal representatives, and assigns and agrees to indemnify and hold Oahu SPCA harmless for all bodily injury, personal injury, illness, amputation, scarring, death, property damage or other losses which includes attorney’s fees and costs of litigation, that result to anyone else or any other entity because of the adoptive parents’ negligence or liability. This includes lone acts of or omissions by the adoptive parent as well as the combined acts of the adoptive parents with others.

13. SEIZING AND IMPOUNDMENT OF ANIMAL

Oahu SPCA makes a lifetime commitment to its animals. If the Adoptive parent should be unable or unwilling to care for the adopted animal, he or she will immediately contact the Oahu SPCA so that the Oahu SPCA may take possession of the animal. The adoptive parents shall not in any circumstances abandon, give away to another animal shelter or rescue group, entity or person, or allow the animal to run away. The adoptive parent shall not surrender the animal to an animal control agency or law enforcement officer. The adoptive parent shall not euthanize or have euthanized any animal that he or she has received from the Oahu SPCA, unless a licensed veterinarian recommends euthanasia.

14. CHANGE OF ADDRESS

In the event that the adoptive parent moves or changes contact information, he or she agrees to contact Oahu SPCA with change of address, and phone number information so that all records can be updated.

15. PHOTOGRAPHIC AND AUDIO RELEASE

The adoptive parent expressly grants Oahu SPCA permission to make photographic, video or audio recordings of the adoptive parent with the animal during participation in an Oahu SPCA or other event. The adoptive parent grants Oahu SPCA rights to all photographic images and or recordings made. This includes but is not limited to, any royalties, proceeds, or other benefits derived from photographs or recordings to promote Oahu SPCA and its mission, including Oahu SPCA events and work and for fundraising and other purposes Oahu SPCA deems appropriate.

16. OTHER

The adoptive parent expressly agrees that this Oahu SPCA Adoption Agreement is meant to be as broad and inclusive as permitted by law. The adoptive parent agrees that in the event that any clause provision of this agreement shall be invaild by any court of competent jurisdiction, the invalidity of such clause provision shall not otherwise affect the remaining provisions of this Agreement. This is the entire Agreement between parties and supersedes any other verbal or written statements, representations or promises. The agreement shall be governed by and interpreted in accordance with the laws of the State of Hawaii. Any disputes under this agreement will be resolved in Honolulu County, Hawaii. All disputes under this Agreement will be settled and binding arbitration.

The Adoptive or Foster parent agrees that he/she is legally competent to enter into this agreement and understands his/her responsibilties. The Adopter or Foster agrees this Agreement is binding upon the heirs, assigns, successors, personal representatives and executors of both parties. (Adoptive Parent and Spouse/Partner).* Please Sign Your Name By Signing Today's Date

Application

Adoption Application Form

General & Contact Info

Adoption Application Form

Home & Lifestyle Info

Adoption Application Form

Employment Info

Adoption Application Form

Pet History, Experience

Adoption Application Form

Agreements

Traditional Adoption

Foster-To-Adopt

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