Furry Friends Animal Rescue Adoption Application

Name:

Street Address:

City: Zipcode: State:

Home Phone: Secondary Phone: Work Phone:

Employer: Occupation:

Spouse/Partner
Name: Occupation:

Employer: Work Phone:

E-mail Address:

Dog Considering:   Breed:  Adoption Fee: $

1. Why do you want to adopt a dog?

2. Have you ever owned a dog before? YesNo

3. What pets do you currently own?
Name of Pet           Type         Breed                     Age          Mo/Yrs      Owned    Mo/Yrs    Indoor/Outdoor?





4. Do you keep your dog on heartworm prevention? YesNo
If Yes, what brand?

5. Where do you purchase it?

6. What brand of dog food are you currently feeding?
If you do not currently have a dog, list previous brand.

7. Are ALL the pets you have spayed or neutered? YesNo
If not, please tell us why:

8. Please list the past pets you have had and explain what happened to them:
Name of Pet          Type          Breed of Pet           Age        Mo/Yrs    Owned    Mo/Yrs

     What happened?


     What happened?


     What happened?


     What happened?

9. Veterinarian reference:
Name: Location: Phone Number:
What name is on your Veterinarian records?

10. Does everyone in your household know you are planning to adopt a dog? YesNo

11. Do you: Own your home Rent Live with parents Other
If renting: HouseApartment
Name of Landlord: Phone Number:

12. Age and relationship of everyone in your household:
Age: Relationship:
Age: Relationship:
Age: Relationship:
Age: Relationship:
Age: Relationship:

13. Do you have a fenced yard? YesNo
If so, what type of fence: How high (in feet) is the fence?

14. If you do not have a fence, how do you plan on confining your dog?

15. Have you ever given up a pet in the past? YesNo
If so, explain:

16. Should you move unexpectedly, what will become of the dog?

17. What behaviors would you consider unacceptable in your dog?

18. Do you agree to keep your dog on a leash while in your company out of doors
and off your property as required by local and state leash laws? YesNo

19. Have you ever tied a dog out for any reason? YesNo
If so, explain:

20. How many hours a day will your dog be alone?

21. Where will the dog stay when alone?

22. Where will the dog sleep?

23. If you travel, how will your dog be cared for?

24. Will the dog be kept: Indoors Outdoors Both?

25. If outdoors, what kind of shelter will be available to protect the dog from the elements?

24. If your dog is not spayed/neutered on the date of adoption due to its age,
will you have it spayed/neutered by its sixth month of age? Yes No

25. Do you agree to forfeit your spay/neuter deposit if terms of #24 are not met? Yes No

26. Are you prepared for the costs involved in properly caring for a dog (such as good quality food, treats, toys, grooming, annual shots, non routine and emergency care, heartworm prevention, and flea/tick control)? Yes No

All of the information I have provided is true and complete to the best of my knowledge. By clicking the "I agree" button below, I agree to provide the dog with good quality food, water, heartworm prevention, shelter, affection and medical care.

Failure to answer all questions completely will delay the processing of your application.

Once this application is reviewed, a SITE VISIT of your home may be scheduled (If a site visit is not possible, three (3) letters of reference may be required, one of which must be from a veterinarian).

Upon approval of this application we can schedule an appointment so that you can meet the dog you are applying for. We may request that you bring existing pets and children to make sure that they all get along well. If all goes well, you may adopt the dog that day and take him/her home with you. At that time, you will sign an ADOPTION CONTRACT. Please bring with you a collar with a name tag and leash.

Thank you for visiting Furry Friends Animal Rescue. We appreciate your desire to welcome one of our very special friends into your home.

"I agree" to the terms outlined above
"I do not agree" to the terms outlined above