Friends for Seniors Application

Animal's Name
Is the animal that you are applying for a dog or cat *
First Name *
Last Name *
Phone Number *
Email Address *
Date of Birth (please see guidelines for age requirements) *
Address *
City *
State *
Zip Code *
Are you in a financial position to provide adequate food, housing, and vet care? *
Explain how you would handle an emergency vet visit. *
Explain your plan for the animal if you are no longer able to care for him/her *
Do you have other pets in the home? What kind? If not please put N/A *
	Dog
	Cat
Do you have kids that visit on a regular basis? *
Explain how you will handle a situation if your new animal does not get along with kids that come to visit *
Do you understand that your new pet needs time to decompress and adjust to your home? *
How much time will you give your new pet to adjust and what will you do to help with this adjustment period? *
Do you have qualities that are important to you? Please check all mandatory qualities below:
	Active
	Lazy
	Male
	Female
	Housebroken
	Crate Trained
	Leash Trained
	Good with dogs
	Good with cats
	Good with kids
	No physical or health issues
Friends for Seniors guidelines: Dogs - animal must be 5+ years old and adopter must be 65+ years old. Cats: Animal of any age qualifies and adopter must be 55 years old. Do you and the animal that you are applying for fit into these guidelines? *
Name of Vet *
Vet Phone *
Reference Name and Number *
Reference Name and Number *
Reference Name and Number *