House Rabbit Society

Preliminary Adoption Application

Thank you for filling out this profile. The information you provide will help us help you find the rabbit who best matches you, your family and your lifestyle. (NOTE: Use the Tab key to move from one field to the next.)

APPLICANT PROFILE

Full Name:

Address:

City:

State:

Zip:

Home Phone:

Work Phone:

Names of others in household and ages:

HOUSING (check all that apply):

Own

Rent

Live with parents

Military

House

Condo

Apartment

Trailer

Other:

Landlord Name: (if applicable)

Landlord Phone Number:

Length of time at above address:

COMPANION ANIMAL HISTORY - Animals currently living with you:

Species:

Name:                                                  

Age:

Sex:

Spayed or Neutered:

Inside:

Outside:

Both:

Length of time living with you:

Species:

Name:                                                  

Age:

Sex:

Spayed or Neutered:

Inside:

Outside:

Both:

Length of time living with you:

YOU AND YOUR HOUSEHOLD

First time adopting a rabbit

Currently live with rabbits

Lived with rabbits who are no longer with me

What happened to him or her:

I am home all day

I am home part-time

I am away 7 - 10 hours daily

Describe your household:

Quiet

Active

Describe expected housing arrangements:

Indoor

Outdoor

Both

Free running

Caged

Both

If caged, describe anticipated time out from cage:

Less than 2 hours/day

2-4 hours/day

4-8 hours/day

All day

Describer the primary caregiver:

Person adopting

Child

Family

TYPE OF RABBIT YOU ARE LOOKING FOR

Small (3-5 lbs.)

Medium (6-8 lbs.)

Large (9-15 lbs.)

Breed preference? Yes: No:

If yes, list:

Baby

Adult

No age preference

Must be litter trained

Willing to litter train

Low activity level

High activity level

No activity level preference

DESIRED CHARACTERISTICS

Confident

Sensitive

Independent

Affectionate

Shy

Easy-going

Curious

Well-mannered

Active

No desired characteristics preference

Additional Comments: