Adoption Application

Animal you are interested in adopting	Marilyn (Dog - A2025014) Nightfur (Cat - U2025012) STEVIE (Dog - D2024035) Sincere (Cat - S2025001) Winston (Dog - A2023109)
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
Date of Birth
Drivers License Number
If you are approved to adopt an animal from FDR, how soon would you be able to take the animal home?
What is your commitment level? We are a foster based rescue and rely on placements to keep their word of commitment. Please only apply if you are ready to take on the animal. *
How did you find out about us?
Have you applied anywhere else for a pet?	NoYes
If yes, where else have you applied for a pet and when? Please provide name of rescue and date.
Please list two personal references (other than family members)/phone numbers/how long you have known them *
Is this pet for you or 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?	NoYes
What is your yearly budget for animal care per year? How much do you think it will be? *
Are you financially equipped to pay the adoption fee and pay for all vetting the animal will need? *
How many pets have you owned in the last 5-10 years?
What happened to them?
Are your pets current on their vaccinations?	NoYes
If you have access to your up to date records please provide a photo.
Have you ever turned your dog or cat into a shelter?	NoYes
If yes, please explain?
Veterinarian's Name If you have never owned a pet please tell us where you would go.
Veterinarian's Address, City, State, and Zip Code Again if you have never owned a pet please list where you would go
Veterinarian's Phone Number
Are you familiar with heartworm and heartworm prevention?	NoYes
If you have pets, will they adjust to a new pet in the house?	Yes No Unsure N/A
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 provide links to your social media *
What is your household lifestyle? Highly active, moderately active, laid back or very low activity? *
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?	Less than one month 1-2 months 3-6 months 6-9 months 9-12 months 1-2 years 3-5 years 6-10 years 10 + years
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 No Possibly N/A
Employment Status	Full-Time Part-Time Retired Work from Home Stay at Home Parent Student Unemployed Other
If you chose "other" above, please explain:
If you are employed, what is your current occupation?
On average, how many hours per day will your pet be left alone?
Will this pet be predominantly living inside, outside, or both?
Please provide a description of this pet's living conditions.
Do you have a completely fenced-in yard? If so, what kind of fence?	Wood Chain Link Electric Plastic Iron Other Other (I do not have a fenced yard)
If you answered "other" above, please explain:
If you do not have a fenced yard, how will you let the animal out?
Are there times when the animal will be tied/chained up?
Are you physically able to walk the animal outside for the appropriate amount of time for it to go to the bathroom? *	NoYes
If yes, when will they be tied/chained up?
Where will the animal sleep?
If you answered "other" above, please explain:
How will you handle destructive behavior?
Will you keep the animal up-to-date on vaccinations and heartworm preventative?	NoYes
If no, please explain:
Are you willing and able to exercise the dog on a regular basis?
If yes, what is the method of exercise?
If you answered "other" above, please explain:
Have you ever been convicted of abuse or neglect of a child or animal?	NoYes
If yes, please explain:
What arrangements will you make for the care of your pets in case of an emergency?
If you answered "other" above, please explain:
For what reasons would you return the pet? Sickness, biting, barking, not housetrained, etc. *
What would you do with your animal if you had to move?
If you answered "other" above, please explain:
Do you agree to a facetime with an FDR team member? As well as a video walkthrough of the home? *	NoYes
I have read the foregoing and certify that the answers I have given are complete, true and not misleading in any way. I also am aware that if any information provided is found to be false, FDR has the right to cancel your application. 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.	Clear