Dog Adoption Application

Please indicate the name of the animal or animals you are interested in adopting.
If you do not hear from us within 72 hours after submitting an application, please check your mail and email info@furballforce.org to confirm *	NoYes
Applicant's First Name
Applicant's Last Name
Street Address
City
State
Apartment Number (if applicable)
Zip Code
Phone Number Please use the following format 248-555-1212
Email Address Please enter correctly as this is the main way we will contact you
Alternate Phone Number
How did you find out about us?	Petfinder Internet Search Family/Friend Staff/Volunteer Facebook/Twitter Other
Have you applied anywhere else for a pet?	NoYes
If yes, where else have you applied for a pet?
Is this pet for you or someone else?	Myself Someone else
Do you own other pets at the current time?	NoYes
If yes, please list their names, breeds, and ages.
Are all of your pets spayed/neutered/fixed?	Yes No N/A
How many pets have you owned in the last 5-10 years?
What happened to them?
Are your pets current on their vaccinations?	Yes no n/a
If yes, please explain?
Veterinarian's Name If you have never owned a pet please tell us where you would go.
Veterinarian's Phone Number
How do you feel about having pets spayed/neutered?	Agree Disagree Not Sure
If you have pets, will they adjust to a new pet in the house? Tell us your plan for integrating the new pet with your existing animals.
Please check the main reason you plan to adopt a pet:	Companion Family Pet Child's Pet Guard Dog Companion for another pet Other
If you answered "other" above, please explain here:
Please describe in detail the pet you are looking for.
Do you own or rent your home?	Own Rent Someone else owns the Home Someone else rents the Home
Please select your current residence type.	House Apartment Condo Townhouse Mobile Home Other
If you answered "other" above, please explain here:
How long have you lived at this address? *
If you rent, does your landlord and lease allow pets?	Yes No Unsure N/A
Including yourself, how many people live in your household?
Please list the ages & relationship of those who live in your home.
Is everyone in your household aware that you are planning to adopt a pet?	Yes No N/A
Does anyone in your household have allergies to dogs/cats?	Yes Cats No Possibly Yes Dogs
If you are employed, what is your current occupation?
On average, how many hours per day will your pet be left alone?
How much do you think the annual medical bills will be for your pet?	About $100 $100 - $200 $200 - $300 $300 - $500 $500 +
What would you do if the bills went over this amount?
Where will the animal sleep?	In bed with me In bed with my child In a dog / cat bed In a kennel / crate Wherever he or she likes Outside Other
If you answered "other" above, please explain:
How will you handle housetraining?
How will you handle destructive behavior?
What arrangements will you make for the care of your pets in case of an emergency? *
What will you do with the animal when you go on vacation? *
If you answered "other" above, please explain:
For what reason(s) would you consider returning/giving up the animal?
What would you do with your animal if you had to move? *
If you answered "other" above, please explain:
Are you willing to take responsibility for this animal for the next 10-20 years?	NoYes
If no, please explain:
Will you allow us to perform home checks?	NoYes
I have read the foregoing and certify that the answers I have given are complete, true and not misleading in any way. I am authorizing you to contact landlords, associations and veterinarians. You are also aware that we cannot guarantee the health and temperament of the animal.	Yes No