Adoption Application

Name of dog you are interested in
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 *
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
Have you ever turned your dog 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 *
Have you ever had a pet euthanized? *	NoYes
If yes, please explain:
How do you feel about having pets spayed/neutered? *	Agree Disagree Not Sure
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 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
Landlords Name *
Landlords Phone Number *
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? *
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? *
Will this pet be predominantly living inside, outside, or both? *	Inside Outside 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? *	Yes No N/A
If yes, when will they be tied/chained up?
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:
Do you have a pool? *	NoYes
Is there a fence around the pool? *	N/A Yes No
What kind of fence do you have around your pool? *	N/A Wood Chain Link Plastic Iron Other
If you answered "other" above, please explain:
How will you handle housebreaking? *
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? *	Yes No N/A
If yes, what is the method of exercise?	Walking Running Dog Park / Dog Run Other
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? *	Leave with family/friend Boarding Pet Sitter Take with me/us Other
If you answered "other" above, please explain:
What will you do with the animal when you go on vacation? *	Leave with family/friend Boarding Pet sitter Take with me/us Other
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? *	Take him / her with me Give to family or friend Return to shelter Other
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
Please provide a name and phone number of 2 references. (NON FAMILY MEMBERS) *
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. *	Clear
PLEASE NOTE: A meet and greet does not guarantee a dog adoption. Furever Friends Sanctuary reserves the right to decline any application if we feel it's not a proper fit for the animal.