Name: *Address *Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeAfghanistanAlbaniaAlgeriaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCentral African RepublicChadChileChinaColombiaComorosCongo (Brazzaville)CongoCosta RicaCote d\’IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast Timor (Timor Timur)EcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambia, TheGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea, NorthKorea, SouthKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPalestinian TerritoryPalauPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint VincentSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of AmericaUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWestern SaharaWestern SamoaYemenZambiaZimbabweCountryPhone: *Alternate Phone: Email: *Please tell us why you are interested in adopting a rabbit: * I have reviewed Ohio House Rabbit Rescue’s adoption policy and I understand that the rabbit must live in a minimum space of 4′ by 4′. I am over 18 years oldHousehold InformationDo you own or rent your home? OwnRentHave you received your landlord's approval? YesNoHow long have you lived at this address? Landlord's Name: Landlord's Phone: My Household Consist of: Adults OnlyFamily with children over 10 years old.Family with young children under 10 years old.Live AlonePlease provide the names and ages of everyone living in your home. For example: Ron, spouse, over 21; Beth, daugher, 13, etc. Name: Relationship: Age: Has anyone in the household been convicted of animal neglect or cruelty in any local, state, or national jurisdication? YesNoHas anyone in the household been involved in breeding rabbits for sale? YesNoThe activity level in my home is: QuietActiveHecticI am… rarely home (sleep there only)at home when not at workhome all day (or someone is there)Pet Ownership & HistoryCurrent pets in household: Type of pet: Age: How Long Owned: Sex: MaleFemaleAltered (Spayed/Neutered): YesNoKept Indoors/Outdoors/Both: Type of Pet: Age: How Long Owned Sex: MaleFemaleAltered (Spayed/Neutered): YesNoKept Indoors/Outdoors/Both: Type of Pet: Age: How Long Owned: Sex: MaleFemaleAltered (Spayed/Neutered): YesNoKept Indoors/Outdoors/Both: Tell Us About your Past Pets: Type of Pet: How Long Owned: Reason No Longer Owned: Who is your veterinarian? Phone: Does anyone in your household have an environmental or animal allergy to: RabbitsHayGrassDoes everyone in your hosehold agree with getting a new rabbit? YesNoWhat kind of research have you done to learn about this kind of animal's needs? Who will be directly responsible for your rabbit's care/feeding/handling? How and where will you house your new rabbit? Please describe in detail the size and location of your new rabbit's habitat. Would you consider adopting an older, shy, or special needs rabbit? Check all that apply. OlderShySpecial NeedsWould you consider adopting a bonded pair? YesNoIs there a particular rabbit that you are interested in? How did you hear about us? Word of Mouth/FriendWebsiteNewspaperTelevisionRadioFacebook/Social MediaOtherIf Other: Under what conditions would you feel it necessary to find another home for your rabbit? I certify that all of the information in this application is true and I understand that false information may void the adoption and future adoptions from Ohio House Rabbit Rescue, Inc. I agree that if I can no longer care for this rabbit, I will return this rabbit to Ohio House Rabbit Rescue, Inc.Signature *Date * Ohio House Rabbit Rescue, Inc. reserves the right to deny adoptions. Our priorities are the health, safety, and future well being of the rabbits in our care and the health, safety, and expectations of people who visit us with hopes of finding a pet who will match their interests, lifestyle, and existing companion animal(s). VerificationPlease enter any two digits with no spaces (Example: 12) *This box is for spam protection – please leave it blank: