Adoption Application

Please note that applicants must be at least 23 years old.

Your Name*

First Last

Please confirm you are aware that our adoption fees for puppies under 6 months: $450 adoption fee plus $150 spay/neuter deposit to be refunded upon proof of spay/neuter, dogs 6 months-7 years is $325.00, dogs 8 to 9 years is $175.00, and over ten years is $100.

Adoption fee acknowledgement*

I am aware of the adoption fees.

Birth Date

We can only accept applications from PA, NJ, MD and DE.

Street Address*

Address Line 2

City*

State*

Zip Code*

What County do you live in?*

Email*

By entering a valid e-mail address, you will receive a confirmation that your application was submitted via e-mail. If you do not get a confirmation, please contact the rescue at info@siberianhuskyrescue.org

Home Phone*

Cell Phone

Occupation/Profession*

Reference #1*

You MUST provide two references of people that are NOT family. You MUST also provide the NAME, PHONE, E-MAIL and relationship of this person.

Reference #2*

Siberian Husky Experience*

Which of the following best describes your experience with Siberian Huskies?

Describe your Husky experience

Please further describe your experience with Siberian Huskies.

Other breed experience

What other breeds of dogs do you have experience with? Tell us about the breeds you have owned in the past.

Current Dogs

List the breeds, ages, and sex of the dogs that currently live in your household and IF THEY ARE SPAYED/NEUTERED.

Other animals*

Please check the box beside each animal that currently resides on your property or in your home.

Other animal comments

Please provide more information about your other pets or list additional species of pets here. If you have cats, tell us if they are indoor/outdoor or both and if they are able to be kept separate from the dogs. If you have birds, were are the cages kept? Anything that will help us to match the dog to your home.

Past pets

Please list any other pets you may have owned in the past

Pets given up

If you have ever given up a dog or other pet, please explain the circumstances here. If you have not given up a pet, please state that here.

Pets lost, stolen, or escaped

Please tell us of any pets that have been lost, stolen or escaped. Include the species, breed, and circumstances.

Own / Rent / Other?*

Pet Approval

Please select the most appropriate statement

Landlord Information

If you rent, provide the name and phone number of your landlord or rental agency.

Home Type*

Years Residing

Yard Description*

Please select the most appropriate statement about your yard

Does your yard have a pool?*

Yes
No

Please describe your pool

Fencing description

Please check the boxes that describe your fence. For example, if you have a 4 Foot Chain Link fence, you should check off 4 foot and Chain Link / Cyclone.

No fence exercise*

If you have no fence, how will you exercise the dog and manage potty detail? Put "n/a" if you have a fully fenced yard.

Number of adults*

How many adults (>18 Years) live in your household?

Number of children*

How many children live in your household?

Ages of children*

List the ages of the children living at home.

Children pet experience

What experience do the children in the household have with pets?

Regular household visitors

Infants and Toddlers
Children 5-10 years
Children 10-17 years
Adults
Other dogs
Other cats / pets

What other visitors come to your home on a regular basis? Check all that apply.

Veterinarian (Primary)*

Please provide us with a name of a vet you currently use or have used in the past. If you are new to pet ownership, please provide the name of the vet you intend to use.

Vet Address*

Street Address Address Line 2 City State ZIP Code

Vet Phone*

Vet status

Veterinarian (Other #1) - optional

Please provide us with a name of a vet you currently use or have used in the past. If you are new to pet ownership, please provide the name of the vet you intend to use.

Vet Address

Street Address Address Line 2 City State ZIP Code

Vet Phone

Vet status

Veterinarian (Other #2) - optional

Please provide us with a name of a vet you currently use or have used in the past. If you are new to pet ownership, please provide the name of the vet you intend to use.

Vet Address

Street Address Address Line 2 City State ZIP Code

Vet Phone

Vet status

Daily Containment

How will your new Siberian Husky spend the day while you are out?

Other containment

If needed, please provide additional information of how your dog will spend its time alone.

Home Alone*

How many hours will your new dog need to spend alone?

Bedtime

In what manner will your dog be confined at bedtime?

Special consideration

Are there any special considerations or needs that you would like to make DVSHR aware of?

Home Check Objection?

Do you object to a home check? If so, please explain why.

How were you referred?

How did you hear about us?

Preferred Dog(s)

Goose
Jasmine
Daisy
Sir Charles
Loba
Tonka
Frankie

Which of the currently available dogs are you interested in adopting? Check all that apply.

Alternate Dog

Would you consider another dog if the one(s) you selected are no longer available?

Timing

Finding the perfect match of Siberian and family can take 2 weeks to 2 months depending on the circumstances. Is this an acceptable timeline for you?

Breed research

Have you educated yourself about the Siberian Husky?

Commitment*

Are you and your family ready for the commitment of owning a Siberian Husky? This includes dedicating time and money to the care and training of the dog and working through life changes such as college, divorce, children etc

Training Commitment*

Most dogs require some level of training to help them adjust to new homes. Please let us know the level of commitment you are willing to provide.

After clicking on Submit, DO NOT REFRESH or RESUBMIT. You will receive a confirmation message (and email) if you successfully submitted your application. If the form still appears, review for missing Required fields and enter the requested information.

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