FJAH Adoption Questionnaire

Applicant's First Name *

Applicant's Last Name *

*

I am 18 years of age or older

What type are you looking for? *

Street Address *

Apartment Number (if applicable)

City *

State *

Zip Code *

Phone Number *

Alternate Phone Number

Email Address (Please enter your email in correctly as this is the main way we will contact you) *

How did you find out about us? *

Are you looking for a pet for youself or someone else? *

Check all that apply: I want the pet for:

Do you have a prefernce for a male or female?

What breed type are you looking for?

Do you have any size requirements when fully grown?

What length or type of hair?

What age range are you looking for?

What is the animal you are interested in adopting?

Have you ever adopted from us before? *

Would this be your first pet? *

Do you currently have any pets at home or have you had pets in the last 12 months? *

If yes, what pets do you have and how many?

Are all of your pets spayed/neutered/fixed and up to on date on vaccines?

Do you currently have a veterinarian?

Are you financially prepared to pay for routine vet are and emergencey medical care? *

Have you ever surrendered or had to give up a pet? *

Do you own or rent your home? *

*

If you are a renter or someone else owns the home, you are responsible for ensuring that you reside in a pet friendly home.

Please select your current residence type. *

How long have you lived at this address?

Including yourself, how many people live in your household? *

Please list the ages & relationship of those who live in your home. *

Do children regularly visit your home? *

What are the ages of the children that visit? *

Does anyone in your household have allergies to dogs/cats? *

On average, how many hours per day will your pet be left alone?

Where will the pet be kept when alone?

In general, where will they be kept during the day?

Where will the animal sleep?

Do you believe pet cats should be let outdoors? *

Are you considering declawing a kitten or cat? *

If you are adopting a dog, how will you keep the animal confined on your property? *

If your newly adopted pet begins to display troubling behavior (i.e. chewing/scratching furniture, having accidents in the house/outside litter box, barking, being destructive) what would you do? *

For what reason(s) would you consider returning/giving up the animal? *

IMPORTANT DISCLAIMER

By submitting this application, you are aware of the following conditions:

Adoptions ARE NOT done on a first come – first serve basis
We have the right to refuse any adoptions

By submitting this form, you specify that you understand the below mentioned conditions.

I acknowledge, agree, and represent that I am aware of and assume the many risks associated with being around animals, including but not limited to the risks of being bitten, scratched, jumped upon, knocked over, chased, tripped, infected with a disease or parasite, or otherwise injured or frightened, as well as the risks of damage to personal property. I have read the foregoing and certify that the answers I have given are complete, true and not misleading in any way. I understand that submitting this form does not guarantee that this animal will be available to adopt. You are also aware that we cannot guarantee the health and temperament of the animal.

In addition, you authorize us to contact any persons listed on this form and to visit your home should we decide to do so.