FOCCAS: Dog Adoption Application

FOCCAS Dog Application

Coos Bay, Oregon
FOCCAS accepts multiple applications and selects homes based on BEST FIT for each pet.

Due to volume of responses, we may not be able to respond to each application. If you are not chosen, we will keep your application on file for the future.

All pets are spayed or neutered before the adoption is finalized, no exceptions.

Submitting this application does not mean you are commiting to a pet, nor does it guarantee you will get that pet. It is simply a tool we use to help both you and us identify a good potential match for your family and lifestyle.

A successful adoption depends on selecting the right pet for your household and a good understanding of the pet's needs and care requirements. Please help us with this process by answering the following questions fully and completely. THANK YOU!
Name of the dog you want to adopt *
Adopter's Name *
First & Last Name
Co-Adopter's Name
First & Last Name
Address *

Street Address

Street Address Line 2

City State

Zip Code
Adopter's Email *
Phone Number *
Phone Number
Names and ages of all residents of your home (adults/children) *
Do you currently have any pets? *

Yes No
If you currently have pets, please list them below. Please include name, species, breed, age, sex, indoor/outdoor.
If you don't currently have pets, please describe your previous experience with dogs.
Are your current pets spayed/neutered?

Yes No
If your current pets are not altered, please explain why below.
Vet reference (please call your vet and give permission to release information to us) *
Vet name, address & phone number
Have you ever had to rehome or return a pet and why? *
Are you familiar with dog regulations in your area? *

Yes No
If you answered no to the question above, please contact your town/county/condo assoc and ask them what the regulations are. You are required to license your dog in Coos County.
I/We live in a *

Single Family Home Duplex/Twin Condo/Townhome Trailer/Mobile Home Apartment RV
Do you rent or own this property? *

Rent Own
If you rent, landlord's name and phone number
Renters: be sure to contact your landlord to find out if there are restrictions on the kind or size of dog you can have or if there is a pet deposit.

Homeowners: have you checked with your Homeowners insurance company to see if there certain breed restrictions?
Do you have a yard? *

Yard, fenced with a vertical fence Yard, fenced with invisible fencing Yard, no fence No yard (apartment/condo/townhome)
What is the height of your fence? *

2' high 3' high 4' high 5' high 6' high No fence
Is your fence dog tight? *

Yes No N/A
How many hours per day will this dog be alone? Please explain. *
Where will this dog sleep at night? *
Have you discussed this adoption with all members of your household? *

Yes No Yes, adults have discussed. Kids don't know yet.
How often do you plan to walk the dog and take them on adventures? *

1-2 times a week 3-4 times a week 5-7 times a week 1-2 times a month Never
What activity/energy level do you prefer? *

Wild and crazy is cool Leash trained daily jogging partner would be excellent Medium energy, plays a bit then hangs out with you Low energy, walks slowly on leash, a total couch potato
What would your dream dog be like? (If this dog is not a fit, we may be able to recommend another based on what you say here.) *
Please check all that apply. I want to adopt this dog... *

As a family pet As a companion for my dog(s) For a jogging/hiking partner To train/use for agility To train/use as a therapy dog To use as a guard dog To train/use for hunting To interact with lots of friends/family As a gift for a friend, partner, or family member As a companion for my cat(s) As a companion for my child/children
Please check all that apply. My adopted dog will...

Be kept indoors most of the time Be kept outside most of the time Be left outside during the work day while we are away Be kept inside while we are away Be crated when we are not home Have free reign of the house when we are not home Be taken to formal obedience classes Be trained by me/us Take frequent car rides with us Be kept on a lead line/cable in the yard Be mostly interacting with adults Be interacting frequently with children under 8 Be interacting frequently with older children Be housetrained by us Must be housebroken prior to adoption Be walked more than one mile per day every day Be walked occasionally Be attending formal group obedience classes with us Be trained by us without the advice of a trainer Have private sessions with a trainer as needed Be attending agility classes Be taking frequent car rides/trips with us Be boarded when we go on vacation Stay with family when we go on vacation Be given away to someone else if we feel it's not a good match for us Be turned in to a shelter if we can't keep it Be going camping with us Be going on boat trips with us Be outside with a dog house in a fenced area Be outside chained/tethered to a dog house Be free roaming on the property (unfenced)
Please take time to think, be honest with yourself and us when answering this question. What are you absolutely NOT willing to deal with at the time of adoption or at any time during the life of the dog? *

Housebreaking Chewing Jumping Pulling on leash during walks Barking Counter surfing Obedience training Fear of men Fear of women Fear of children Separation Anxiety Mouthiness (may sometimes snag your hand or arm instead of the toy in play and will need redirection/training) Growling Rough play with my dog High activity level Food/toy aggression/not willing to share with other dogs Food/toy aggression with people Whining/crying Blindness Limited Sight Deafness Diabetes Special Diet Long Term Medication Incontinence / Leaking Urine Taking classes with the dog Gets stressed/carsick when riding in vehicle Can't climb stairs due to age/arthritis/health issues Skin allergies Food allergies Trimming nails Yeast on coat or in ears Ear mites Fleas Ticks Heartworm preventative
What would cause you to return a dog? *
What do you feel is a reasonable amount of time for a dog to adjust to life with you/your family? *
What brand of dog food do you plan to feed? *
What type of flea preventative do you plan to use *
Grooming (please check all that apply) *

We use a professional groomer We trim dog nails ourselves at home We bathe our dogs at home once a week We bathe our dogs at home once a month We bathe our dogs at home once every few months or whenever their coat feels dirty We bathe our dog twice a year We don't bathe our dog We check ears weekly for infection/yeast/mites We clean teeth using home methods We take our dogs to the vet for dentals whenever the vet recommends this is needed Prefer a dog that doesn't shed Don't care about shedding
Would you be willing to allow a FOCCAS representative to make a home visit at a mutually agreed upon time? *

Yes No
The adoption of a pet is a lifetime commitment. Are you willing to make the investment in both time and finances to care for and properly manage your new forever friend? *

Yes No
Do you have any additional comments, questions or concerns? Anything else you would like us to know to help match you up to a dog? *
Feel free to email us with any questions:

coosfoccas@gmail.com

I understand that completing this application does not guarantee I will be allowed to adopt a dog. FOCCAS reserves the right to reject any application based on information obtained during this screening process. Please understand that our primary goal is the health, happiness, and safety of our rescued dogs.

I acknowledge that all information provided on this form is true and correct. I understand that any misrepresentations may result in my not being approved and/or removal of the adopted dog from my possession. I also certify that I have never been convicted of animal cruelty or neglect.

I agree to allow a representative from FOCCAS to contact my vet for a reference and also agree to allowing a home visit prior to adopting this dog. If I am approved to adopt a dog, I agree to pay a non-refundable adoption fee and hand sign an adoption contract at the time of adoption.

After hitting “submit” you will be returned to our website. You will also receive a confirmation email.
Please read the above, check this box, sign, and click Submit. *

I/We have read and understand all of the above.
Applicant's Signature *
Co-Applicant's Signature
Signature date *
Should be Empty:

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FOCCAS Dog Application