Animal Adoption Application ARP

Animal Adoption Application
Name*

First NameLast Name
Your Phone Number*

Area CodePhone Number
Email
example@example.com
How old are you? (must be 25 years to adopt)*
What animal are you interested in adopting? (Species, name)*
Your Address*

Street Address

Street Address Line 2

CityState

Zip Code
Phone Type*

CellHomeWork
Social Media Handle
Activity level you desire?*
Lazy/couch potato, medium activity, high activity, etc
Names and ages of all permanent residents of your home (adults/children)*
If there are children, please write about their experience with dogs or if you are expecting
Why are you interested in adopting a dog and what's your ideal pet?
Occupation?*
You work:*

OfficeAt homeDog friendly officeHybridRetired
How long will the pet be home alone on a daily basis?*
You live in a:*

Single Family HomeDuplex/TwinCondo/TownhomeTrailerApartment
Do you:

OwnRentRent with roommatesOther
If you rent, do you have permission to own a dog? Are there any breed restrictions?*
If you rent, please include your landlords contact name + number
Do you have a yard?*

Yard, fenced with a vertical fenceYard, fenced with invisible fencingYard, no fenceNo yard (apartment/condo/townhome)
Do you have a pool?*

YesNo
If you have a pool, is it gated or open?*

GatedOpen
Do you have a fenced yard? If so, what type and how tall? Any area where the dog could slip through or hop over?*
Do you have a gate? Is there a lock on the gate?*
Will you dog be?:*

Indoor onlyIndoor + outdoorOutdoor only
When you're at home, where will your pet be? *
Free roaming, in a room, in a crate, outside, etc
Where will the pet sleep?
a crate, on the floor in your room, in bed w/ you, etc
Please list any pets currently living in your home, and if they are vaccinated and altered.*
If you have a yard, who has access to it? *
Ex: gardener, pool person, neighbors, friends, etc
Vet reference (please call your vet and give notice that we will call. If you have not been to a vet before, please register with one soon.)*
Vet name, address & phone number
Are you planning to move in the near future?*

YesNo
If moving soon, to what city/state?
When will you be ready to adopt this animal?*

TodayThis weekendWithin a weekWithin a monthNot ready yet, just researching
Is anyone in your home allergic to the animal you're planning to adopt?*

YesNoYes, but it is tolerable for them and they are OK with it.
Are you familiar with the breed?*

YesNo
If yes, briefly explain
If you answered no to the question above, please visit Google and do a bit of research so you can be prepared for your new family member!
If you rent, you must give the person you are adopting from a written letter from your landlord or a copy of the section of your lease stating that you are allowed to have this type of animal and showing any limitations.

If you live in a condo or townhome, you must show us written proof that you are allowed to have this type of animal there and show any restrictions.
What areas of your home will the dog have access to? Any they not have access to?*
Have you discussed this adoption with all members of your household?*

YesNoYes, adults have discussed. Kids don't know yet.
Please be aware that dogs/cats given as gifts for the holiday season are usually returned to shelters or given to pounds after the New Year's. With this in mind, please make sure that any animal you are adopting will be a permenant resident.
If applicable, will your children be taught how to play gently and kindly with this animal?*

YesNoNo children
Vet bills can be expensive. How do you plan on paying them? (IE: Pet health insurance)*
Additional reference (if desired)
Do you have any additional comments, questions or concerns?*
How did you hear of us?

Social MediaFriendWebsiteM/S volunteer or adopterOtheronline search
If referred by a M/S adopter, volunteer, or friend, we'd love to know who!
Are you willing to pay a $500 adoption fee?*
By checking the box below, you understand the terms of this form and adoptee. You hereby agree that you will not use this animal in any fighting, breeding, or cruelty. You will love and care for this animal for the rest of its life and are ready to commit to that. You also agree, that if for any circumstances you can no longer provide love and care for this animal, you will contact an admin of the group and return said animal to Maison Sûre Foundation. You also agree to spay/neuter your pet and are responsible for all medical care moving forward. You accept full responsibility for the dog(s) actions at all times, and release Maison Sûre Foundation from any liabilities or damages that may be incurred because of such dog.The animal mentioned above will live and sleep indoors and will be treated as a true member of your family.

I understand the above, and have tried to the best of my knowledge to make sure all information is correct.
Adopter's Signature*
Signature date*
Thank you for taking the time to submit this form. Please feel free to contact me (the person you are adopting from) or any of the admins in the Adopt/Rehome network. After you click the Submit, you will be redirected to the main page, and you will also recieve a confirmation email. Thank you!
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