Please copy this application from the web site, paste it into an email message, complete the application, and send it to the Chapter Manager, Davida, at hazelbert@roadrunner.com. Davida does not have MS WORD on her home computer so please do not send the application as a WORD document as that will cause a delay. Thanks!

If you are under 18, then have a parent or guardian fill out this application.

Full Name ________________________
Address _________________________________________
City_________________________
Home # and best time to call ______________________
Work # _______________________
Cell # _________________________
Any alternate email address ___________________
Are you 18 year old or over? _____ yes _____ no.
How did you hear of NYSHRS ?

• Internet: Petfinders
• Internet: www.therabbitresource.org
• Internet: www.rabbit.org
• Your veterinarian
• another HRS member
• shelter
• other _______________________

The HRS requires a home visit before adoption to make sure we make a good family-bunny match. HRS volunteers making home visits will discuss the rabbit environment, rabbit handling, and bunny proofing the home. Will you permit a HRS volunteer to visit your home? ___________________

Our adoption fee is $65 and only partially defrays our vet costs since the spay/neuter fee for a rabbit is itself more than $65. Is the $65 fee acceptable to you? ____________________________________

Your age and occupation __________________________________________________

Please list ALL members of your household, and ages
________________________________________________________
________________________________________________________
________________________________________________________

Please list ALL current pets
________________________________________________________
_________________________________________________________

Do you have any experience with bunnies? Was you bunny spayed/neutered? _______________________________________________________

If you do not have any bunny experience, do you need help with information/resources? ________________________________________________________

Have you read House Rabbit Handbook and the national website, www.rabbit.org ? ________________________________________________________

Do you currently own a rabbit? ________________________________________________________

If so, is s/he spayed/neutered? are there current health problems? ________________________________________________________

May we contact your current veterinarian (if you have one) for a reference (please list the name)? ________________________________________________________

If you do not have a veterinarian at present, who would be your veterinarian if you adopt a rabbit (please list name)? ________________________________________________________

Where is your rabbit housed? (Or, where would a new rabbit be housed if you adopt a bunny?) ________________________________________________________

How much exercise time was provided, or would be provided for a new rabbit? ________________________________________________________

What diet do you feed, or would you feed if you adopt a rabbit? ________________________________________________________

Who in the household was responsible for your rabbit's care, or would be responsible for a new rabbit? ________________________________________________________

Do you ever allow your rabbit outdoors, or would you allow a new rabbit outdoors? ________________________________________________________

What would you do if your rabbit did something which you considered undesirable -- like excessively chewing? ________________________________________________________

If you currently rent, does your landlord permit you to have a rabbit? ________________________________________________________

If you are looking for a partner for your current rabbit, please tell us about your pet's personality. ________________________________________________________

Which bunnies on our website interest you? ________________________________________________________

How far can you drive to visit foster homes? ________________________________________________________

Thank you for your application. You will be contacted shortly by your regional coordinator for NYSHRS. A home visit is usually done, and an adoption contract is required. Our adoption fee is $65. We do not ship rabbits, but once the screening is completed if there is a rabbit in our system in another part of the state who interests you, we can sometimes arrange part way transportation. Thank you.

Please email the completed application to the Chapter Manager at: hazelbert@roadrunner.com