Furever Friends and Rescue - Pet Adoption Application

Furever Friends and Rescue

Small and Mighty Pet Rescue. Saving one pet at a time. fureverfriendsandrescue@gmail.com
Pet Adoption Application
Name of Furever Friends and Rescue Animal You Are Interested In Adopting
Applicant's Name:

First NameMiddle NameLast Name
Date Of Birth

MonthDayYear
Address :

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Phone :

Area CodePhone Number
Cell Phone :

Area CodePhone Number
Email Address :
example@example.com
Your Employer
Occupation
Do you have a Spouse or Partner? (Joint Applicant)
Spouse or Partner Name

First NameLast Name
Description of Residence
How long have you lived here?
Years
Months
Home Ownership :
Landlord's Name :
Landlord's Phone :

Area CodePhone Number
Number of adults in the home :
Number of children in the home :
Age(s) of children :
example: 5,9,13
Please list anyone living in the home not mentioned above:
Pets Currently in Your Household (check all that apply) :
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) :
Were They Spayed/Neutered?
Where Were They Kept?
Time Owned & What Happened to Them?
Veterinarian Information
Do you have a Veterinarian?
Name of Veterinarian :
Veterinarian Phone :

Area CodePhone 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?
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 a Furever Friends and Rescue representative?
Best day/time for follow-up visit? (if you happen to adopt)
What amount of time will this pet be inside? hours*
What amount of time will this pet be outside? hours*
What amount of time will this pet be inside?
amount of hours
What amount of time will this pet be outside?
amount of hours
If adopting an outside pet, what kind of shelter do you have?
Do you have a fenced yard?
Do you have a shaded area?
(For a Dog) Do you realize that an outdoor dog may entertain itself by digging, chewing home items and/or escaping and wandering?
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?
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?
Who will perform the surgery?
Will you have this pet vaccinated annually, by a veterinarian, against infectious disease?
Will you maintain your pet on heart-worm preventative?
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?
(For a Dog) How will you keep the dog confined to your property? (Check all that apply)

Other
Have you applied to adopt from this rescue before today?
If so, Date*
Was Pet Adopted?
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 #1:
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number

Area CodePhone Number
Relationship:
Reference #2
Reference #:2
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number

Area CodePhone Number
Relationship:
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

MonthDayYear
Date Signed
Should be Empty: