Furever Friends And Rescue

Pet Adoption Application

Name of Furever Friends and Rescue Animal You Are Interested In Adopting *

Applicant"s Name: *

First Name Middle Name Last Name

Address : *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Home Phone :

Area Code Phone Number

Cell Phone : *

Area Code Phone Number

Email Address : *

example@example.com

Description of Residence *

House Apartment Mobile Home Duplex

How long have you lived here?

Years *

Months *

Home Ownership : *

Landlord"s Name : *

Landlord"s Phone : *

Area Code Phone Number

Number of adults in the home : *

Number of children in the home : *

Age(s) of children : *

example: 5,9,13

Pets Currently in Your Household (check all that apply) : *

Dog Cat Other None

How Many Pets in Your Household? *

Weight of Each Pet in the Household? *

Are They Spayed/Neutered? *

Where Are They Kept? *

Time Owned & Age(s) of Each Pet : *

List Previous Pet(s) : *

Dog Cat Other None

Were They Spayed/Neutered? *

Where Were They Kept? *

Time Owned & What Happened to Them? *

Are You at Least Eighteen(18) Years of Age? *

Yes No

Veterinarian Information

Do you have a Veterinarian? *

Yes No

Name of Veterinarian : *

Veterinarian Phone : *

Area Code Phone Number

How long have you used this vet? *

Years

Responsibility and Home Visit :

Who will be responsible for the daily care/feeding of this pet? *

Who will financially support this pet? *

Where will you keep this pet? *

Where will you keep this pet when you TRAVEL? *

Do all members of the household WANT this pet? *

If you have young children, they need to be educated on how to interact with the pet in order to prevent bites. Are you willing/able to do that? *

Yes No

How long will you give this pet to adjust to its new home? *

How many hours will this pet spend alone? *

If you must give up this pet, what would you do with it? *

Would you agree to a follow-up home visit by the Furever Friends and Rescue?

Yes No

Best day/time for follow-up visit? *

What amount of time will this pet be inside? hours*
What amount of time will this pet be outside? hours*

If adopting an outside pet, what kind of shelter do you have? *

Do you have a fenced yard? *

Yes No N/A

Do you have a shaded area? *

Yes No N/A

(For a Dog) Do you realize that an outdoor dog may entertain itself by digging, chewing home items and/or escaping and wandering? *

Yes No N/A

What will you do if your pet shows destructive behavior (i.e. digging, chewing, jumping, tearing up plants/furniture or running off)? *

Do you realize that you might have to house-train your new pet? *

Would you like information on house-training? *

Yes No

How many times a day will you exercise your pet? *

What form of exercise will your pet receive? *

Will you have your pet SPAYED OR NEUTERED within the recommended time frame? *

Yes No N/A

Who will perform the surgery? *

Will you have this pet vaccinated annually, by a veterinarian, against infectious disease? *

Yes No

Will you maintain your pet on heart-worm preventative? *

Yes No

Do you realize that dogs often live longer than 10 years and cats longer than 15? Are you willing to assume responsibility for that long? *

Yes No

(For a Dog) How will you keep the dog confined to your property? (Check all that apply) *

House Kennel Fence Chain Patio Garage Leash

Have you applied to adopt from this rescue before today? *

Yes No

If so, Date*

Was Pet Adopted? *

Yes No

Where is that animal now? *

References :

Please provide the name, address, and telephone number of two (2) references and their relationship to you.
Please only include one (1) family member.

Reference #1 *

Reference #2 *

I certify the above is true and that false information my result in nullifying this adoption. Furever Friends and Rescue has the right to refuse adoption to anyone. I understand that no animal can be held for me. I know and agree that Furever Friends and Rescue can reclaim the animal if they feel it is not being kept in acceptable conditions.

Furever Friends and Rescue operates on donations and money raised. All donations are at your discretion and are non-refundable.

Signature *

Date *

Date Signed