Forever Home Rescue New England Adoption Application
1. Name of dog you are interested in:
2. Name of second choice dog:
3. Applicant first and last name:
*
First Name
Last Name
4. Co-applicant first and last name:
First Name
Last Name
5. Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
6. Home Phone
7. Have you adopted from us before?
8. Have you been approved by another dog rescue, and if so, which?
APPLICANT'S INFORMATION
9. Age
10. Gender
male
female
11. Cell Number
-
Area Code
Phone Number
12. E-mail
*
13. Employer:
14. Town/City of Employment:
15. Work Phone #:
-
Area Code
Phone Number
16. Position:
17. Work hours per day including Commute:
Co-Applicant Information
18. Age
19. Gender:
male
female
20. Cell Number
-
Area Code
Phone Number
21. Email Address:
22. Employer:
23. Town/City of Employment:
24. Work Phone #:
-
Area Code
Phone Number
25. Position:
26. Work Hours / day including commute:
About Your Home
27. Type of Residence:
Please Select
Please Select
House
Apartment
Condo
Mobile
28. Do you:
Please Select
Please Select
Own
Rent
Live with parents
Other
29. if other:
30. If you rent, landlord's name:
31. Landlord's Phone #:
-
Area Code
Phone Number
32. Landlord's Email:
33. Do you have a fenced yard?
yes
no
34. Is it enclosed?
yes
no
35. If yes, type of fence:
36. Sq. Ft.:
37. Height:
38. If no, would you be willing to have one installed?
yes
no
39. if no, why not?
40. If no, how will you keep your dog safe?
ABOUT YOUR FAMILY
41. Number of other adults in your household:
42. Adults
Rows
Age:
Gender:
Adult #1:
Adult #2:
Adult #3:
Adult #4:
43. Number of children in your household:
44. Children
Rows
Age:
Gender:
Child #1:
Child #2:
Child #3:
Child #4:
45. Describe your children's experience with dogs, if any.
46. If you do not have any children living with you, will your rescue dog come into regular contact with children under the age of 8?
yes
no
47. If yes, how often?
48. What ages?
49. Does anyone in your household have allergies?
yes
no
50. If yes, please explain:
51. Does anyone in your household have behavorial problems or disabilities?
yes
no
52. If yes, please explain:
53.Is everyone in your household aware of and in agreement with adopting a rescue dog?
yes
no
54. If not, who is not in favor and what are their concerns or objections?
ABOUT YOUR PETS, PAST AND PRESENT
55. Please list current pets living with you (excluding fish). If no pets, leave blank.
Rows
Pet's Name
Type i.e. dog/cat
Breed (dog only)
Age
Gender
Spayed/Neutered?
How long owned
1
2
3
4
5
6
56. Previous DOG(S) you owned within the past 10 years. If none, leave blank.
Rows
Pet's Name
Breed
Age
Gender
Spayed/Neutered?
How long owned
What happened to dog?
How long ago
1
2
3
4
5
6
57.Have you ever had to rehome a dog, or return a dog to a shelter or rescue, and if so, why?
58. If you have never been the primary caretaker of a dog, please describe your dog experiences:
59. Current veterinarian:
60. Phone Number
-
Area Code
Phone Number
61. Previous veterinarian:
62. Phone #:
-
Area Code
Phone Number
PLANS FOR YOUR RESCUE DOG
63. Who will be the primary caretaker for the dog?
64. When no one is home, the dog will be:
Crated
Have free run of the house
Restricted to certain room
Kept outdoors
65. How will you exercise your dog?
66. How long will your dog be left alone on a regular basis?
TWO PERSONAL REFERENCES REQUIRED
67. First reference: Full Name
First Name
Last Name
Relationship to applicant:
Phone Number
-
Area Code
Phone Number
68. Second reference: Full Name
First Name
Last Name
Relationship to applicant:
Phone Number
-
Area Code
Phone Number
Enter the message as it's shown
*
Type a question
Submit
Should be Empty: