Dog Adoption Form

Friends of Animals - Dog Adoption Application
This application must be completed by anyone interested in adopting a dog. We reserve the right to refuse an adoption for any reason. All applicants must be 21 years of age or older and provide a valid form of government issued identification. We want this to be a wonderful experience for your family, but our first responsibilty is to ensure the health, welfare and happiness of the animals in our care.
Name of dog(s) you are interested in:*
Personal Information
Name of Applicant:*
Applicant's Age:
Applicant's Spouse's Name:
Spouse's Age
Current Address:*
Street Address, Apartment #, City, State and ZIP Code
Home Phone:
Work Phone:
Mobile Phone:
Email Address:*
Occupation:
Employer:
How long have you been employed with this company?
Why do you want to adopt a dog?
Home Information
Where do you live?

ApartmentRental HomeOwn HomeCondoMobile Home
If you rent, do you have the landlord's permission to own a dog?

YesNo
What is the cost of the pet security deposit?
May we call your landlord or property manager?

YesNo
Landlord or property manager's name:
Landlord or property manager's phone number:
How many times have you moved in the past 5 years?
Suppose you move to an apartment or rental that does not accept pets. What would you do?
Does anyone in the household smoke? (Some dogs are allergic to smoke)

YesNo
Do you foresee any major changes in your life in the next 15 years (average life span of a dog) such as marriage, children, health problems or going away to college?

Yes (Explain below)No
If you answered "Yes" to the question above, please explain.
Do you have a fenced in yard with no gaps?

YesNo
If you answered "Yes", please describe the fence:
Tell how high and what kind
Number of adults in household?
Describe their relationship to you?
How many children live in the household?
Describe the children:
Please list gender and age of each child.
Do all family members know of your plans to adopt a dog?

YesNo
Do any family members have animal allergies?

YesNo
If you answered "Yes" to the previous question, please explain:
Please list current pets:
Please describe number, age and species for each pet
If any of your current pets live outdoors, please describe.
Are your current pets spayed or neutered?

YesNo
Where do your current pets sleep? (be specific)
Where do your current pets stay when home alone? (be specific)
Have you always kept a collar and ID tag on your pets at all times?

YesNo
How many pets have you owned in the past?
Where are the pets now? (be specific)
If you have ever had a serious behavior problem with a previous pet, please explain.
Were all previous pets spayed or neutered?

YesNo
Do you know what heartworm disease is and how to prevent it?

YesNo
Is your current dog (or previous one) on heartworm preventive medication?

YesNo
How often and which brand?
How do you plan to prevent fleas and ticks?
How to you feel about spaying or neutering your pet?
How many hours will your new dog be home alone on a typical day?
Where will the new dog stay when home alone?

Outside in fenced areaOutside in a dog penFree run outsideIn a crateOutside on a chain, tie-out or runnerIn the garageIn the basement"Baby-gated" in a kitchen or other roomFree run of the houseOther (describe below)
If you answered "Other" to the previous question, please give details.
Where will your new pet sleep an night?

In crateIn basementDoghouse with tie-outDoghouse in fenced areaIn one room of the houseDog house in a dog runFree run of the houseIn the garageOn floor in your bedroomIn kitchenIn your bedIn child's roomFree run outsideOther (describe below)
If youy answered "Other" the question above, please give details.
What percentage will your dog spend inside and outside.
Please choose an option...
Do you have a doggie door?

YesNo
Would you consider putting one in?

YesNo
What would you expect vet care, heartworm and flea preventative medicine to cost yearly?
What type of house breaking procedure do you use?
Under what circumstances do you think it is okay to let a dog outside unattended?

In a quiet subdivisionOn a lot of acreageIn an invisible fence areaIn the mountainsWhenever the dog wantsOnly in a secure fenced areaWhen the dog knows home and comes back when he is calledOther (Explain below)
If you answered "Other" to the previous question, please explain in detail.
Which of the following reasons would you give up your dog?

MovingNew babyNot getting along with other petsDivorceGetting out of the fenceBehavioral problemsSheddingChildren lost interestIncrease work hoursAllergiesNot housebrokenMedical problemsBarkingGets too bigNot getting along with childrenAggressiveNoneOther (Please describe below)
If you answered "Other" to the question above, please give details.
If you have ever had to give up an animal, please explain the circumstances:
What type of pet food do you intend to feed your dog?
Has a dog died on your premises of distemper, parvo or unknown causes?

YesNo
Suppose your pet develops a medical problem that becomes expensive (some medical treatments can cost thousands of dollars). What would you do?
Suppose your pet develops a frequent urination problem at the age of 12. You work 8 hours a day and he can't hold his bladder that long. What would you do?

Have him put to sleep since he is older"Babygate" him in a place where flooring is not carpetedGive him to a rescue group or shelterPut in a doggie doorOther (describe below)
If you answered "Other" to the previous question, please give details.
If you date or marry someone who does not like or want your pet(s), what would you do? Please elaborate:
How do you feel about dogs being on your furniture?
If you are adopting a dog with longer hair, will you groom it?

YesNo
If you answered "Yes" to the question above, how often?
How did you hear about us?

RadioNewspaperWeb siteWord of mouth
Have you ever looked at or applied for a pet with another rescue group?

YesNo
How long ago?
Did you adopt? Please explain.
Do you object to an unannounced home visit by a representative from our organization?

YesNo
Name of veterinarian or clinic:
May we call them?

YesNo
What is their phone number?
Personal References
Please list below names and phone numbers of three friends, relatives, co-workers or neighbors. Also list their relationship to you.
Reference #1
Please list name, phone number and relationship.
Reference #2
Please list name, phone number and relationship.
Reference #3
Please list name, phone number and relationship.
I hereby attest that all the information given in this application is true and accurate to the best of my knowledge. A check represents your signature. Falsification of any of the above information will be grounds for disallowing the adoption of resuce dog and possible removal of said pet from my home.

YesNo
Date

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Friends of Animals - Dog Adoption Application

Personal Information

Home Information

Personal References