Rescue Dog Adoption Application

Adoption Application

Fur-Get Me Not Animal Rescue Inc.
Applicant Information
Name of the dog you are interested in:*
Your full name:*
Your age:*
Street Address:*
City, State, Zip*
Home Phone:

Area CodePhone Number
Work Phone:

Area CodePhone Number
Cell Phone:

Area CodePhone Number
E-mail:
Employer:
Phone Number

Area CodePhone Number
Years at current employer
Name and phone number of 2 references not related and not living with you*
Co-Applicant

First NameLast Name
Age:
Home Phone

Area CodePhone Number
Cell Phone

Area CodePhone Number
Household Information
Are all members of your household in agreement with this adoption?*

YesNoDon't Know
Who will be the pet's primary caregiver?*
Do you live in a*

HouseApartmentCondoMobile HomeOther
Do you own or rent?*

OwnRent
If rent, provide name and phone number of landlord/ type Own if applicable:*
Does your landlord allow dogs?

YesNo
Are there any restrictions from your landlord, homeowner's association, or county/township restrictions?*

Number of petsSize or weight restrictionsBreed restrictionsNone
Do you have a fully fenced yard?*

YesNo
Height and type of fence
Do you have any of the following?

Underground fenceKennelDog Run
How many adults are in your household?*
How many children are in your household?*
If children, what are their ages?
Have your children been around animals before?

YesNo
Does anyone in your home have allergies to dogs or have asthma?*

YesNo
Who will care for the dog while you are away or on vacation?*
In the event you pass away or no longer able to care for the dog do have arrangements for your pets continued care, if so describe*
Current/Previous Pet Information
List any pets you own or have owned in the past ten years, and their ages*
Where are these animals now?*
Are all of these pets are spayed/neutered?*
Are all pets up to date on vaccinations?*
Do you use heart worm preventative?*
Have you adopted from an animal welfare group before?*

YesNo
If yes, what group?
Have you ever given up a pet?*

YesNo
If yes, what were the circumstances?
Please provide the name and phone number of your current and/or previous veterinarian or clinic:*
New Pet Information
What type of personality do you want your pet to have? (i.e. calm, energetic, protective, couch-potato)*
Are you aware of crate training?*

YesNo
Have you ever house-broken a dog or puppy before?*

YesNo
If the dog has an "accident" in your home, what type of correction do you plan to use?*
How many hours each day will your new pet be home alone?*
Where will your new pet sleep at night?*
How will you supervise the dog's outdoor activity?*
Where will your new dog stay when nobody is home?*
What length of time will you allow your new pet to adjust to his new home?*
Are you willing to work through your new pet's issues, if any?*

YesNo
Are you aware that a new environment is stressful for your pet, and they may exhibit uncharacteristic behavior?*

YesNo
Do you understand that a dog can be an 18 year commitment, and can cost $300 - $500 per year to care for?*

YesNo
Most of our dogs available for adoption have undergone temperament evaluations and have lived with foster families prior to their adoption. While in foster care, we begin training and work to resolve any known behavioral obstacles before adoption. Generally, we are only able to give you the dog's history from the time it enters our program. Are you able and willing to continue working on these challanges to ensure your adopted dog is a respectable canine companion.
I have read and understand above and will work with my adopted dog to overcome any behavioral issues*

YesNo
Do you agree to only use positive reinforcement methods of training as opposed to physical methods (i.e. hitting, punching, slapping etc)?*

YesNo
Do you plan to take an obedience class with your dog?*

YesNoNot sure
If yes, where?
Name

First NameLast Name
Are you aware that a large breed dog takes about two years to mature? Is this something you're prepared for?*

YesNo
What circumstances would lead you to give up your new dog?*
If you had to give up your dog, what would you do with him/her?*
We ask for an adoption fee to help cover the cost of spay/neuter, vaccinations, microchipping, transport, training and foster care. Fees range from $150 to $350. Do you agree to pay the adoption fee associated with the animal?*

YesNo
I certify that the information provided in the application above is accurate, true and correct. I am financially and physically capable of caring for the animal I adopt. I understand and agree that falsification of any of the above information is grounds to reject my adoption application and nullify all adoption(s) and/or adoption agreements. I understand that there is no obligation to adopt an animal to me, now or in the future. I understand that my electronically generated signature is valid and legally binding for purposes of this application.
I have read and agree to the terms above*

YesNo
Signature

First NameLast Name
Mobile and tablet users may sign with a stylus or finger. PC users please use mouse to sign.
Date

MonthDayYear
How did you find out about us?*

Adoptapet.comPetfinder.comFacebookFriend/Family MemberOther websitePetSmartOther
Should be Empty:

Adoption Application

Applicant Information

Household Information

Current/Previous Pet Information

New Pet Information