{"id":37247,"date":"2017-05-31T12:20:38","date_gmt":"2017-05-31T17:20:38","guid":{"rendered":"http:\/\/www.hsni.org\/?page_id=37247"},"modified":"2025-01-21T11:40:33","modified_gmt":"2025-01-21T17:40:33","slug":"dog-adoption-form","status":"publish","type":"page","link":"https:\/\/www.hsni.org\/?page_id=37247","title":{"rendered":"Dog Adoption Form"},"content":{"rendered":"<p><a href=\"http:\/\/www.hsni.org\/wp-content\/uploads\/2018\/11\/Newest-logo.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignright wp-image-45868 size-medium\" src=\"http:\/\/www.hsni.org\/wp-content\/uploads\/2018\/11\/Newest-logo-300x202.jpg\" alt=\"\" width=\"300\" height=\"202\" srcset=\"https:\/\/www.hsni.org\/wp-content\/uploads\/2018\/11\/Newest-logo-300x202.jpg 300w, https:\/\/www.hsni.org\/wp-content\/uploads\/2018\/11\/Newest-logo-600x403.jpg 600w, https:\/\/www.hsni.org\/wp-content\/uploads\/2018\/11\/Newest-logo-768x516.jpg 768w, https:\/\/www.hsni.org\/wp-content\/uploads\/2018\/11\/Newest-logo-1024x688.jpg 1024w, https:\/\/www.hsni.org\/wp-content\/uploads\/2018\/11\/Newest-logo.jpg 1465w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a>At the Humane Society of North Iowa, we seek responsible homes for our animals, where owners fulfill the physical, veterinary and emotional needs of their pets. Pet ownership is a very important commitment and it is our goal to ensure all pet adoptions will be a permanent placement for every animal.<\/p>\n<p>Adopters must be at least 18 years old. All adults in the household must participate in this application and selection process. We may require a valid form of identification bearing the applicant\u2019s current address. Renters must supply their landowner\u2019s name and phone number. Veterinary care and housing arrangements for applicants\u2019 current pets must meet HSNI standards.<\/p>\n<p>By signing this application, the applicant gives express permission for the HSNI to investigate all statements made on this application. Specifically, the applicant gives the HSNI permission to inquire of and obtain veterinary care records for the applicant\u2019s current or past pets. Also, for applicants who rent their dwelling, the Humane Society will contact the current landowner to confirm permission for applicant to house an indoor pet on the property. The Humane Society of North Iowa reserves the right to refuse any adoption application.<\/p>\n<script type=\"text\/javascript\">\n\/* <![CDATA[ *\/\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in Gravity Forms 3.1.\"),o(),0))},initializeOnLoaded:function(o){gform.callIfLoaded(o)||(document.addEventListener(\"gform_main_scripts_loaded\",()=>{gform.scriptsLoaded=!0,gform.callIfLoaded(o)}),document.addEventListener(\"gform\/theme\/scripts_loaded\",()=>{gform.themeScriptsLoaded=!0,gform.callIfLoaded(o)}),window.addEventListener(\"DOMContentLoaded\",()=>{gform.domLoaded=!0,gform.callIfLoaded(o)}))},hooks:{action:{},filter:{}},addAction:function(o,r,e,t){gform.addHook(\"action\",o,r,e,t)},addFilter:function(o,r,e,t){gform.addHook(\"filter\",o,r,e,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n\/* ]]> *\/\n<\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gform_legacy_markup_wrapper gform-theme--no-framework' data-form-theme='legacy' data-form-index='0' id='gform_wrapper_6' ><div id='gf_6' class='gform_anchor' tabindex='-1'><\/div>\n                        <div class='gform_heading'>\n                            <h3 class=\"gform_title\">Dog Adoption Form<\/h3>\n                        <\/div><form method='post' enctype='multipart\/form-data' target='gform_ajax_frame_6' id='gform_6'  action='\/index.php?rest_route=%2Fwp%2Fv2%2Fpages%2F37247#gf_6' data-formid='6' novalidate>\n                        <div class='gform-body gform_body'><ul id='gform_fields_6' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_6_74\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_74'>Name of Dog applying for:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_74' id='input_6_74' type='text' value='' class='medium'  aria-describedby=\"gfield_description_6_74\"   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_6_74'>List the name of the dog you are interested in adopting. List additional names if you are interested in meeting multiple dogs. Type \"unsure\" if you haven't selected a specific dog.<\/div><\/li><li id=\"field_6_1\" class=\"gfield gfield--type-name gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_6_1'>\n                            \n                            <span id='input_6_1_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.3' id='input_6_1_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_6_1_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_6_1_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.6' id='input_6_1_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_6_1_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/li><li id=\"field_6_2\" class=\"gfield gfield--type-name field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Spouse\/Partner\/Roommate&#039;s Name<\/label><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_6_2'>\n                            \n                            <span id='input_6_2_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_2.3' id='input_6_2_3' value=''   aria-required='false'     \/>\n                                                    <label for='input_6_2_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_6_2_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_2.6' id='input_6_2_6' value=''   aria-required='false'     \/>\n                                                    <label for='input_6_2_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/li><li id=\"field_6_3\" class=\"gfield gfield--type-address gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Address<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label>    \n                    <div class='ginput_complex ginput_container has_street has_street2 has_city has_state has_zip ginput_container_address gform-grid-row' id='input_6_3' >\n                         <span class='ginput_full address_line_1 ginput_address_line_1 gform-grid-col' id='input_6_3_1_container' >\n                                        <input type='text' name='input_3.1' id='input_6_3_1' value=''    aria-required='true'    \/>\n                                        <label for='input_6_3_1' id='input_6_3_1_label' class='gform-field-label gform-field-label--type-sub '>Street Address<\/label>\n                                    <\/span><span class='ginput_full address_line_2 ginput_address_line_2 gform-grid-col' id='input_6_3_2_container' >\n                                        <input type='text' name='input_3.2' id='input_6_3_2' value=''     aria-required='false'   \/>\n                                        <label for='input_6_3_2' id='input_6_3_2_label' class='gform-field-label gform-field-label--type-sub '>Address Line 2<\/label>\n                                    <\/span><span class='ginput_left address_city ginput_address_city gform-grid-col' id='input_6_3_3_container' >\n                                    <input type='text' name='input_3.3' id='input_6_3_3' value=''    aria-required='true'    \/>\n                                    <label for='input_6_3_3' id='input_6_3_3_label' class='gform-field-label gform-field-label--type-sub '>City<\/label>\n                                 <\/span><span class='ginput_right address_state ginput_address_state gform-grid-col' id='input_6_3_4_container' >\n                                        <select name='input_3.4' id='input_6_3_4'     aria-required='true'    ><option value='' ><\/option><option value='Alabama' >Alabama<\/option><option value='Alaska' >Alaska<\/option><option value='American Samoa' >American Samoa<\/option><option value='Arizona' >Arizona<\/option><option value='Arkansas' >Arkansas<\/option><option value='California' >California<\/option><option value='Colorado' >Colorado<\/option><option value='Connecticut' >Connecticut<\/option><option value='Delaware' >Delaware<\/option><option value='District of Columbia' >District of Columbia<\/option><option value='Florida' >Florida<\/option><option value='Georgia' >Georgia<\/option><option value='Guam' >Guam<\/option><option value='Hawaii' >Hawaii<\/option><option value='Idaho' >Idaho<\/option><option value='Illinois' >Illinois<\/option><option value='Indiana' >Indiana<\/option><option value='Iowa' selected='selected'>Iowa<\/option><option value='Kansas' >Kansas<\/option><option value='Kentucky' >Kentucky<\/option><option value='Louisiana' >Louisiana<\/option><option value='Maine' >Maine<\/option><option value='Maryland' >Maryland<\/option><option value='Massachusetts' >Massachusetts<\/option><option value='Michigan' >Michigan<\/option><option value='Minnesota' >Minnesota<\/option><option value='Mississippi' >Mississippi<\/option><option value='Missouri' >Missouri<\/option><option value='Montana' >Montana<\/option><option value='Nebraska' >Nebraska<\/option><option value='Nevada' >Nevada<\/option><option value='New Hampshire' >New Hampshire<\/option><option value='New Jersey' >New Jersey<\/option><option value='New Mexico' >New Mexico<\/option><option value='New York' >New York<\/option><option value='North Carolina' >North Carolina<\/option><option value='North Dakota' >North Dakota<\/option><option value='Northern Mariana Islands' >Northern Mariana Islands<\/option><option value='Ohio' >Ohio<\/option><option value='Oklahoma' >Oklahoma<\/option><option value='Oregon' >Oregon<\/option><option value='Pennsylvania' >Pennsylvania<\/option><option value='Puerto Rico' >Puerto Rico<\/option><option value='Rhode Island' >Rhode Island<\/option><option value='South Carolina' >South Carolina<\/option><option value='South Dakota' >South Dakota<\/option><option value='Tennessee' >Tennessee<\/option><option value='Texas' >Texas<\/option><option value='Utah' >Utah<\/option><option value='U.S. Virgin Islands' >U.S. Virgin Islands<\/option><option value='Vermont' >Vermont<\/option><option value='Virginia' >Virginia<\/option><option value='Washington' >Washington<\/option><option value='West Virginia' >West Virginia<\/option><option value='Wisconsin' >Wisconsin<\/option><option value='Wyoming' >Wyoming<\/option><option value='Armed Forces Americas' >Armed Forces Americas<\/option><option value='Armed Forces Europe' >Armed Forces Europe<\/option><option value='Armed Forces Pacific' >Armed Forces Pacific<\/option><\/select>\n                                        <label for='input_6_3_4' id='input_6_3_4_label' class='gform-field-label gform-field-label--type-sub '>State<\/label>\n                                      <\/span><span class='ginput_left address_zip ginput_address_zip gform-grid-col' id='input_6_3_5_container' >\n                                    <input type='text' name='input_3.5' id='input_6_3_5' value=''    aria-required='true'    \/>\n                                    <label for='input_6_3_5' id='input_6_3_5_label' class='gform-field-label gform-field-label--type-sub '>ZIP Code<\/label>\n                                <\/span><input type='hidden' class='gform_hidden' name='input_3.6' id='input_6_3_6' value='United States' \/>\n                    <div class='gf_clear gf_clear_complex'><\/div>\n                <\/div><\/li><li id=\"field_6_4\" class=\"gfield gfield--type-phone gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_4'>Phone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_4' id='input_6_4' type='tel' value='' class='medium'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_6_5\" class=\"gfield gfield--type-email gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_5'>Email<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_5' id='input_6_5' type='email' value='' class='medium'    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                        <\/div><\/li><li id=\"field_6_6\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >Are you at least 18 years old?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_6_6'>\n\t\t\t<li class='gchoice gchoice_6_6_0'>\n\t\t\t\t<input name='input_6' type='radio' value='Yes'  id='choice_6_6_0'    \/>\n\t\t\t\t<label for='choice_6_6_0' id='label_6_6_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_6_6_1'>\n\t\t\t\t<input name='input_6' type='radio' value='No'  id='choice_6_6_1'    \/>\n\t\t\t\t<label for='choice_6_6_1' id='label_6_6_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_6_7\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >Do you attend school?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_6_7'>\n\t\t\t<li class='gchoice gchoice_6_7_0'>\n\t\t\t\t<input name='input_7' type='radio' value='Yes'  id='choice_6_7_0'    \/>\n\t\t\t\t<label for='choice_6_7_0' id='label_6_7_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_6_7_1'>\n\t\t\t\t<input name='input_7' type='radio' value='No'  id='choice_6_7_1'    \/>\n\t\t\t\t<label for='choice_6_7_1' id='label_6_7_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_6_8\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_8'>Place of employment<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_8' id='input_6_8' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_6_9\" class=\"gfield gfield--type-phone gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_9'>Work Phone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_9' id='input_6_9' type='tel' value='' class='medium'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_6_10\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_10'>How long?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_10' id='input_6_10' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_6_11\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_11'>Spouse\/Partner\/Roommate&#039;s place of employment?<\/label><div class='ginput_container ginput_container_text'><input name='input_11' id='input_6_11' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_6_14\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_14'>How long?<\/label><div class='ginput_container ginput_container_text'><input name='input_14' id='input_6_14' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_6_15\" class=\"gfield gfield--type-select gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_15'>Do you live in a:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_15' id='input_6_15' class='medium gfield_select'    aria-required=\"true\" aria-invalid=\"false\" ><option value='House' >House<\/option><option value='Apartment' >Apartment<\/option><option value='Condo' >Condo<\/option><option value='Dorm\/Student Housing' >Dorm\/Student Housing<\/option><option value='Mobile Home' >Mobile Home<\/option><option value='Farm\/Acreage' >Farm\/Acreage<\/option><\/select><\/div><\/li><li id=\"field_6_16\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >If you live in a home do you:<\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_6_16'>\n\t\t\t<li class='gchoice gchoice_6_16_0'>\n\t\t\t\t<input name='input_16' type='radio' value='Own your home'  id='choice_6_16_0'    \/>\n\t\t\t\t<label for='choice_6_16_0' id='label_6_16_0' class='gform-field-label gform-field-label--type-inline'>Own your home<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_6_16_1'>\n\t\t\t\t<input name='input_16' type='radio' value='Rent your home'  id='choice_6_16_1'    \/>\n\t\t\t\t<label for='choice_6_16_1' id='label_6_16_1' class='gform-field-label gform-field-label--type-inline'>Rent your home<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_6_16_2'>\n\t\t\t\t<input name='input_16' type='radio' value='Live with my parents'  id='choice_6_16_2'    \/>\n\t\t\t\t<label for='choice_6_16_2' id='label_6_16_2' class='gform-field-label gform-field-label--type-inline'>Live with my parents<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_6_17\" class=\"gfield gfield--type-name field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >If you rent: Landowner&#039;s Name<\/label><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_6_17'>\n                            \n                            <span id='input_6_17_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_17.3' id='input_6_17_3' value=''   aria-required='false'     \/>\n                                                    <label for='input_6_17_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_6_17_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_17.6' id='input_6_17_6' value=''   aria-required='false'     \/>\n                                                    <label for='input_6_17_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/li><li id=\"field_6_19\" class=\"gfield gfield--type-phone field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_19'>If you rent: Landowner&#039;s Phone<\/label><div class='ginput_container ginput_container_phone'><input name='input_19' id='input_6_19' type='tel' value='' class='medium'    aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_6_20\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >Have you ever adopted a pet from a shelter before?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_6_20'>\n\t\t\t<li class='gchoice gchoice_6_20_0'>\n\t\t\t\t<input name='input_20' type='radio' value='Yes'  id='choice_6_20_0'    \/>\n\t\t\t\t<label for='choice_6_20_0' id='label_6_20_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_6_20_1'>\n\t\t\t\t<input name='input_20' type='radio' value='No'  id='choice_6_20_1'    \/>\n\t\t\t\t<label for='choice_6_20_1' id='label_6_20_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_6_21\" class=\"gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_21'>If yes, what shelter?<\/label><div class='ginput_container ginput_container_text'><input name='input_21' id='input_6_21' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_6_22\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >Have you ever been refused adoption of a pet from a shelter?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_6_22'>\n\t\t\t<li class='gchoice gchoice_6_22_0'>\n\t\t\t\t<input name='input_22' type='radio' value='Yes'  id='choice_6_22_0'    \/>\n\t\t\t\t<label for='choice_6_22_0' id='label_6_22_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_6_22_1'>\n\t\t\t\t<input name='input_22' type='radio' value='No'  id='choice_6_22_1'    \/>\n\t\t\t\t<label for='choice_6_22_1' id='label_6_22_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_6_23\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >Have you ever released a companion animal to a shelter?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_6_23'>\n\t\t\t<li class='gchoice gchoice_6_23_0'>\n\t\t\t\t<input name='input_23' type='radio' value='Yes'  id='choice_6_23_0'    \/>\n\t\t\t\t<label for='choice_6_23_0' id='label_6_23_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_6_23_1'>\n\t\t\t\t<input name='input_23' type='radio' value='No'  id='choice_6_23_1'    \/>\n\t\t\t\t<label for='choice_6_23_1' id='label_6_23_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_6_24\" class=\"gfield gfield--type-textarea field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_24'>If yes, please explain:<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_24' id='input_6_24' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_6_25\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >Have you ever been involved with an Animal Control Department or other law enforcement agencies regarding your pet or another animal?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_6_25'>\n\t\t\t<li class='gchoice gchoice_6_25_0'>\n\t\t\t\t<input name='input_25' type='radio' value='Yes'  id='choice_6_25_0'    \/>\n\t\t\t\t<label for='choice_6_25_0' id='label_6_25_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_6_25_1'>\n\t\t\t\t<input name='input_25' type='radio' value='No'  id='choice_6_25_1'    \/>\n\t\t\t\t<label for='choice_6_25_1' id='label_6_25_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_6_26\" class=\"gfield gfield--type-textarea field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_26'>If yes, please explain:<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_26' id='input_6_26' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_6_27\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2 class=\"gsection_title\">Household Information<\/h2><\/li><li id=\"field_6_28\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_28'>Number of adults<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_28' id='input_6_28' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_6_29\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_29'>Number of children<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_29' id='input_6_29' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_6_30\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_30'>Ages of children<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_30' id='input_6_30' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_6_31\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_31'>Which member of your household will be responsible for feeding your new dog?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_31' id='input_6_31' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_6_77\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_77'>Which member of your household will be responsible for the veterinarian care of your new dog?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_77' id='input_6_77' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_6_78\" class=\"gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_78'>Which member of your household will be responsible for training your new dog?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_78' id='input_6_78' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_6_33\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >Are any members of your household allergic to animals?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_6_33'>\n\t\t\t<li class='gchoice gchoice_6_33_0'>\n\t\t\t\t<input name='input_33' type='radio' value='Yes'  id='choice_6_33_0'    \/>\n\t\t\t\t<label for='choice_6_33_0' id='label_6_33_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_6_33_1'>\n\t\t\t\t<input name='input_33' type='radio' value='No'  id='choice_6_33_1'    \/>\n\t\t\t\t<label for='choice_6_33_1' id='label_6_33_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_6_34\" class=\"gfield gfield--type-textarea field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_34'>If yes, please explain:<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_34' id='input_6_34' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_6_36\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Please tell us why you want to adopt this dog. Check all that apply:<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_6_36'><li class='gchoice gchoice_6_36_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_36.1' type='checkbox'  value='Gift'  id='choice_6_36_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_36_1' id='label_6_36_1' class='gform-field-label gform-field-label--type-inline'>Gift<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_6_36_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_36.2' type='checkbox'  value='For a child'  id='choice_6_36_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_36_2' id='label_6_36_2' class='gform-field-label gform-field-label--type-inline'>For a child<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_6_36_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_36.3' type='checkbox'  value='Companion to another pet'  id='choice_6_36_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_36_3' id='label_6_36_3' class='gform-field-label gform-field-label--type-inline'>Companion to another pet<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_6_36_4'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_36.4' type='checkbox'  value='Companion for myself'  id='choice_6_36_4'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_36_4' id='label_6_36_4' class='gform-field-label gform-field-label--type-inline'>Companion for myself<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_6_36_5'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_36.5' type='checkbox'  value='As a guard dog'  id='choice_6_36_5'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_6_36_5' id='label_6_36_5' class='gform-field-label gform-field-label--type-inline'>As a guard dog<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_6_37\" class=\"gfield gfield--type-textarea gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_37'>How do you plan to correct problems such as: Barking?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_37' id='input_6_37' class='textarea medium'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_6_38\" class=\"gfield gfield--type-textarea gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_38'>Chewing?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_38' id='input_6_38' class='textarea medium'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_6_39\" class=\"gfield gfield--type-textarea gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_39'>Fence jumping?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_39' id='input_6_39' class='textarea medium'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_6_40\" class=\"gfield gfield--type-textarea gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_40'>Aggressive behavior?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_40' id='input_6_40' class='textarea medium'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_6_41\" class=\"gfield gfield--type-textarea gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_41'>How do you plan to house-break the dog?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_41' id='input_6_41' class='textarea medium'  aria-describedby=\"gfield_description_6_41\"   aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><div class='gfield_description' id='gfield_description_6_41'>Some dogs are already housebroken, but may still have accidents as they adjust to a new home.<\/div><\/li><li id=\"field_6_42\" class=\"gfield gfield--type-textarea gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_42'>If you move in the future, what will you do with your pet(s)?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_42' id='input_6_42' class='textarea medium'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_6_43\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >A dog may live 10+ years. Are you prepared to make a commitment to this dog for its lifetime?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_6_43'>\n\t\t\t<li class='gchoice gchoice_6_43_0'>\n\t\t\t\t<input name='input_43' type='radio' value='Yes'  id='choice_6_43_0'    \/>\n\t\t\t\t<label for='choice_6_43_0' id='label_6_43_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_6_43_1'>\n\t\t\t\t<input name='input_43' type='radio' value='No'  id='choice_6_43_1'    \/>\n\t\t\t\t<label for='choice_6_43_1' id='label_6_43_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_6_44\" class=\"gfield gfield--type-textarea gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_44'>For what reason would you return this animal to the Humane Society?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_44' id='input_6_44' class='textarea medium'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_6_45\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >Some dogs take several weeks or longer to adjust to their new home. Is this acceptable?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_6_45'>\n\t\t\t<li class='gchoice gchoice_6_45_0'>\n\t\t\t\t<input name='input_45' type='radio' value='Yes'  id='choice_6_45_0'    \/>\n\t\t\t\t<label for='choice_6_45_0' id='label_6_45_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_6_45_1'>\n\t\t\t\t<input name='input_45' type='radio' value='No'  id='choice_6_45_1'    \/>\n\t\t\t\t<label for='choice_6_45_1' id='label_6_45_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_6_47\" class=\"gfield gfield--type-textarea gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_47'>What type of characteristics\/traits are you looking for in a dog? (Include size, sex, breed)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_47' id='input_6_47' class='textarea medium'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_6_48\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >Are you aware that regular preventative medical attention (heartworm, flea\/tick treatment), annual vaccinations  and vet exam may cost several hundred dollars annually?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_6_48'>\n\t\t\t<li class='gchoice gchoice_6_48_0'>\n\t\t\t\t<input name='input_48' type='radio' value='Yes'  id='choice_6_48_0'    \/>\n\t\t\t\t<label for='choice_6_48_0' id='label_6_48_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_6_48_1'>\n\t\t\t\t<input name='input_48' type='radio' value='No'  id='choice_6_48_1'    \/>\n\t\t\t\t<label for='choice_6_48_1' id='label_6_48_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_6_49\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >Are you aware that emergency\/life-saving medical care may cost hundreds of dollars or more?<\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_6_49'>\n\t\t\t<li class='gchoice gchoice_6_49_0'>\n\t\t\t\t<input name='input_49' type='radio' value='Yes'  id='choice_6_49_0'    \/>\n\t\t\t\t<label for='choice_6_49_0' id='label_6_49_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_6_49_1'>\n\t\t\t\t<input name='input_49' type='radio' value='No'  id='choice_6_49_1'    \/>\n\t\t\t\t<label for='choice_6_49_1' id='label_6_49_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_6_79\" class=\"gfield gfield--type-radio gfield--type-choice gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >Are you aware that food, supplies, and obedience training may cost several hundred dollars annually?<\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_6_79'>\n\t\t\t<li class='gchoice gchoice_6_79_0'>\n\t\t\t\t<input name='input_79' type='radio' value='Yes'  id='choice_6_79_0'    \/>\n\t\t\t\t<label for='choice_6_79_0' id='label_6_79_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_6_79_1'>\n\t\t\t\t<input name='input_79' type='radio' value='No'  id='choice_6_79_1'    \/>\n\t\t\t\t<label for='choice_6_79_1' id='label_6_79_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_6_51\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_51'>How many hours per day (on average) will your new dog be without human companionship?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_51' id='input_6_51' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_6_52\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_52'>For how many days a week?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_52' id='input_6_52' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_6_53\" class=\"gfield gfield--type-textarea gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_53'>What arrangements will you make for your pet(s) when you leave for extended periods?(vacations, etc)<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_53' id='input_6_53' class='textarea medium'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_6_54\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_54'>Where will the dog be kept during the day?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_54' id='input_6_54' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_6_55\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_55'>Where will the dog sleep at night?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_55' id='input_6_55' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_6_56\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >Do you understand the state laws\/local ordinances that require vaccinating, leashing, and licensing dogs?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_6_56'>\n\t\t\t<li class='gchoice gchoice_6_56_0'>\n\t\t\t\t<input name='input_56' type='radio' value='Yes'  id='choice_6_56_0'    \/>\n\t\t\t\t<label for='choice_6_56_0' id='label_6_56_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_6_56_1'>\n\t\t\t\t<input name='input_56' type='radio' value='No'  id='choice_6_56_1'    \/>\n\t\t\t\t<label for='choice_6_56_1' id='label_6_56_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_6_58\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_58'>What types of identification will you place on your dog?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_58' id='input_6_58' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_6_59\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >Do you have a fenced yard?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_6_59'>\n\t\t\t<li class='gchoice gchoice_6_59_0'>\n\t\t\t\t<input name='input_59' type='radio' value='Yes'  id='choice_6_59_0'    \/>\n\t\t\t\t<label for='choice_6_59_0' id='label_6_59_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_6_59_1'>\n\t\t\t\t<input name='input_59' type='radio' value='No'  id='choice_6_59_1'    \/>\n\t\t\t\t<label for='choice_6_59_1' id='label_6_59_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_6_60\" class=\"gfield gfield--type-textarea field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_60'>If fenced, please describe the height and type of fencing:<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_60' id='input_6_60' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_6_61\" class=\"gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >If not fenced, do you plan to fence?<\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_6_61'>\n\t\t\t<li class='gchoice gchoice_6_61_0'>\n\t\t\t\t<input name='input_61' type='radio' value='Yes'  id='choice_6_61_0'    \/>\n\t\t\t\t<label for='choice_6_61_0' id='label_6_61_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_6_61_1'>\n\t\t\t\t<input name='input_61' type='radio' value='No'  id='choice_6_61_1'    \/>\n\t\t\t\t<label for='choice_6_61_1' id='label_6_61_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_6_62\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >Do you have a dog house or other outdoor shelter?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_6_62'>\n\t\t\t<li class='gchoice gchoice_6_62_0'>\n\t\t\t\t<input name='input_62' type='radio' value='Yes'  id='choice_6_62_0'    \/>\n\t\t\t\t<label for='choice_6_62_0' id='label_6_62_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_6_62_1'>\n\t\t\t\t<input name='input_62' type='radio' value='No'  id='choice_6_62_1'    \/>\n\t\t\t\t<label for='choice_6_62_1' id='label_6_62_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_6_63\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >Will you use a rope, chain, or cable as the sole means of confining this dog?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_6_63'>\n\t\t\t<li class='gchoice gchoice_6_63_0'>\n\t\t\t\t<input name='input_63' type='radio' value='Yes'  id='choice_6_63_0'    \/>\n\t\t\t\t<label for='choice_6_63_0' id='label_6_63_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_6_63_1'>\n\t\t\t\t<input name='input_63' type='radio' value='No'  id='choice_6_63_1'    \/>\n\t\t\t\t<label for='choice_6_63_1' id='label_6_63_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_6_64\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_64'>How will your dog be prevented from running at large and\/or roaming?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_64' id='input_6_64' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_6_80\" class=\"gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_80'>How many times per day will you take this dog outside?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_80' id='input_6_80' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_6_76\" class=\"gfield gfield--type-list field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Please list any and all pets that currently reside in your household or that you have owned during the past FIVE years.<\/label><style type=\"text\/css\">\n\n\t\t\t\t\t\tbody .ginput_container_list table.gfield_list tbody tr td.gfield_list_icons {\n\t\t\t\t\t\t\tvertical-align: middle !important;\n\t\t\t\t\t\t}\n\n\t\t\t\t\t\tbody .ginput_container_list table.gfield_list tbody tr td.gfield_list_icons img {\n\t\t\t\t\t\t\tbackground-color: transparent !important;\n\t\t\t\t\t\t\tbackground-position: 0 0;\n\t\t\t\t\t\t\tbackground-size: 16px 16px !important;\n\t\t\t\t\t\t\tbackground-repeat: no-repeat;\n\t\t\t\t\t\t\tborder: none !important;\n\t\t\t\t\t\t\twidth: 16px !important;\n\t\t\t\t\t\t\theight: 16px !important;\n\t\t\t\t\t\t\topacity: 0.5;\n\t\t\t\t\t\t\ttransition: opacity .5s ease-out;\n\t\t\t\t\t\t    -moz-transition: opacity .5s ease-out;\n\t\t\t\t\t\t    -webkit-transition: opacity .5s ease-out;\n\t\t\t\t\t\t    -o-transition: opacity .5s ease-out;\n\t\t\t\t\t\t}\n\n\t\t\t\t\t\tbody .ginput_container_list table.gfield_list tbody tr td.gfield_list_icons a:hover img {\n\t\t\t\t\t\t\topacity: 1.0;\n\t\t\t\t\t\t}\n\n\t\t\t\t\t\t<\/style><div class='ginput_container ginput_container_list ginput_list'><table class='gfield_list gfield_list_container'><colgroup><col id='gfield_list_76_col_1' class='gfield_list_col_odd' \/><col id='gfield_list_76_col_2' class='gfield_list_col_even' \/><col id='gfield_list_76_col_3' class='gfield_list_col_odd' \/><col id='gfield_list_76_col_4' class='gfield_list_col_even' \/><col id='gfield_list_76_col_5' class='gfield_list_col_odd' \/><col id='gfield_list_76_col_6' class='gfield_list_col_even' \/><\/colgroup><thead><tr><th scope=\"col\">Pet Name:<\/th><th scope=\"col\">Type\/Breed:<\/th><th scope=\"col\">Age:<\/th><th scope=\"col\">Spayed\/Neutered:(Yes or No)<\/th><th scope=\"col\">Still own? (Yes or No, if no:why not?)<\/th><td>&nbsp;<\/td><\/tr><\/thead><tbody><tr class='gfield_list_row_odd gfield_list_group'><td class='gfield_list_cell gfield_list_76_cell1' data-label='Pet Name:'><input aria-invalid='false'   aria-label='Pet Name:, Row 1' data-aria-label-template='Pet Name:, Row {0}' type='text' name='input_76[]' value=''   \/><\/td><td class='gfield_list_cell gfield_list_76_cell2' data-label='Type\/Breed:'><input aria-invalid='false'   aria-label='Type\/Breed:, Row 1' data-aria-label-template='Type\/Breed:, Row {0}' type='text' name='input_76[]' value=''   \/><\/td><td class='gfield_list_cell gfield_list_76_cell3' data-label='Age:'><input aria-invalid='false'   aria-label='Age:, Row 1' data-aria-label-template='Age:, Row {0}' type='text' name='input_76[]' value=''   \/><\/td><td class='gfield_list_cell gfield_list_76_cell4' data-label='Spayed\/Neutered:(Yes or No)'><input aria-invalid='false'   aria-label='Spayed\/Neutered:(Yes or No), Row 1' data-aria-label-template='Spayed\/Neutered:(Yes or No), Row {0}' type='text' name='input_76[]' value=''   \/><\/td><td class='gfield_list_cell gfield_list_76_cell5' data-label='Still own? (Yes or No, if no:why not?)'><input aria-invalid='false'   aria-label='Still own? (Yes or No, if no:why not?), Row 1' data-aria-label-template='Still own? (Yes or No, if no:why not?), Row {0}' type='text' name='input_76[]' value=''   \/><\/td><td class='gfield_list_icons'>   <a href='javascript:void(0);' class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 10)' onkeypress='gformAddListItem(this, 10)'><img src='https:\/\/www.hsni.org\/wp-content\/plugins\/gravityforms\/images\/list-add.svg' alt='' title='Add a new row' \/><\/a>   <a href='javascript:void(0);' class='delete_list_item' aria-label='Remove this row' onclick='gformDeleteListItem(this, 10)' onkeypress='gformDeleteListItem(this, 10)' style=\"visibility:hidden;\"><img src='https:\/\/www.hsni.org\/wp-content\/plugins\/gravityforms\/images\/list-remove.svg' alt='' title='Remove this row' \/><\/a><\/td><\/tr><\/tbody><\/table><\/div><\/li><li id=\"field_6_66\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_66'>Who is your veterinarian for the above pet(s)?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_66' id='input_6_66' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_6_82\" class=\"gfield gfield--type-text gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_82'>Who&#039;s name are the veterinarian records under?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_82' id='input_6_82' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_6_67\" class=\"gfield gfield--type-phone gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_67'>Vet Clinic Phone<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_67' id='input_6_67' type='tel' value='' class='medium'   aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_6_68\" class=\"gfield gfield--type-textarea gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_68'>What vaccinations has your pet had in the past year?<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_68' id='input_6_68' class='textarea medium'     aria-required=\"true\" aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_6_69\" class=\"gfield gfield--type-textarea field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_69'>When was your pet&#039;s last visit to a veterinarian? Reason?<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_69' id='input_6_69' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_6_85\" class=\"gfield gfield--type-textarea gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_6_85'>If you&#039;ve never owned a pet before, or have not owned any pets in the past 5 years, please describe any past pet experience you may have:<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_85' id='input_6_85' class='textarea medium'      aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/li><li id=\"field_6_71\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2 class=\"gsection_title\">By signing below, I certify that the information I have given is true and that I recognize that any misrepresentation of facts may result in my losing the privilege of adopting or keeping an adopted pet. I understand that the Humane Society of North Iowa has the right to deny my request to adopt an animal, and I authorize investigation of all statements in this application. I understand that this application is the property of the Humane Society of North Iowa.<\/h2><\/li><li id=\"field_6_86\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2 class=\"gsection_title\">We often receive multiple applications for the same animal. If your application is not approved, it does not mean you would be a bad home or owner. 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);} ); \n\/* ]]> *\/\n<\/script>\n\n<h2 style=\"text-align: center;\"><span style=\"color: #000000;\">Thank you for submitting your Adoption Application. Our Shelter Management staff will review your application and be in touch with you soon.\u00a0 In the meantime, if you have any questions or would like additional information, please don\u2019t hesitate to call us: <\/span><span style=\"color: #000000;\">641-423-6241<br \/>\nThank you!<\/span><\/h2>\n<p><a href=\"http:\/\/www.hsni.org\/wp-content\/uploads\/2018\/05\/transparant-logo.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-medium wp-image-42311\" src=\"http:\/\/www.hsni.org\/wp-content\/uploads\/2018\/05\/transparant-logo-300x218.jpg\" alt=\"\" width=\"300\" height=\"218\" srcset=\"https:\/\/www.hsni.org\/wp-content\/uploads\/2018\/05\/transparant-logo-300x218.jpg 300w, https:\/\/www.hsni.org\/wp-content\/uploads\/2018\/05\/transparant-logo-600x437.jpg 600w, https:\/\/www.hsni.org\/wp-content\/uploads\/2018\/05\/transparant-logo-768x559.jpg 768w, https:\/\/www.hsni.org\/wp-content\/uploads\/2018\/05\/transparant-logo-1024x746.jpg 1024w, https:\/\/www.hsni.org\/wp-content\/uploads\/2018\/05\/transparant-logo.jpg 1078w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/a><\/p>\n<iframe src='http:\/\/www.facebook.com\/plugins\/like.php?href=https%3A%2F%2Fwww.hsni.org%2F%3Fpage_id%3D37247&amp;layout=button_count&amp;show_faces=true&amp;width=280&amp;action=recommend&amp;colorscheme=light&amp;height=30' scrolling='no' frameborder='0' style='border:none; overflow:hidden; height:30px' allowTransparency='true'><\/iframe>","protected":false},"excerpt":{"rendered":"<p>At the Humane Society of North Iowa, we seek responsible homes for our animals, where owners fulfill the physical, veterinary and emotional needs of their pets. 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