Thank you for your interest in adoption.

Please fill in the form below and provide as much detail as possible.

Name
Name
Address
Address
Include contact e-mail if possible.
Name of Spouse
Name of Spouse
If applicable
Spouse
Spouse
Names and age
Name, age and relationship
Feeding, walking, training, vet trips
Vacation, fall ill
Larger dogs may require larger fences
Parks, doggy day care, training schools
Downstairs, specific rooms
please provide details
Species, breed, age, sex
Please provide details, including the cause of death of past pets
Name of clinic and contact details
10 - 16 years approximately
Please tick any of these scenarios for which you feel you would not be able to keep the dog.
please specify
If so please provide as much information as possible
If you are accepted as an adopter, how do you intend to financially support the dog?
please specify
If you have alternative arrangements, please specify
How did you discover Harbin SHS
If applicable, please specify
If applicable, please specify
I confirm that by checking the proceeding box and submiting this form that all details given are accurate and true to the date of submission. I understand that this form and it's contents will remain on record and will be added to the adoption materials if my application is successful. I confirm that I understand that the completion of this form does not guarantee the adoption of any Harbin SHS animal and I understand that Harbin SHS reserves the right to refuse any application on any grounds for which they beleive the applicant isnt suitable for adoption *
Date *
Date