Adoption Form Adoption Application Applicant Information First Name: Last Name: Age: Occupation: Co-applicant (Spouse or Significant Other): First Name: Last Name: Age: Occupation: Contact Information Street address: City: State: ZIP: Home Phone: Cell Phone: E-mail: Section 1: Dog Information What is the name of the dog you are interested in? List any general questions you would like to ask about this particular dog: Are you willing to allow a representative from Forgotten Paws Pet Rescue to visit your home by appointment? YesNo Why are you adopting a dog? Things that turn you off about a pet: SheddingDroolingBarkingDiggingJumping Will this dog be a surprise for any family members? YesNo If yes, who? Section 2: Home Information Please indicate where you live: ApartmentHouseCondo/TownhouseTrailer/Mobile Home Do you... RentOwn If you rent, do you have the landlord's permission to own a dog? YesNo What is the apartment complex name? What is the landlord's phone number? How much is the pet deposit? $ How many times have you moved in the past 5 years? If you move, will your pet go with you? YesNo What would you do with your pet if you were to move to a place that didn't accept it? Do you have a fully fenced yard with no fence gaps? YesNo If yes, how high and what kind? WoodenChainlinkSplit Rail with wireOther If no, would you consider fencing all or part of it as a condition of adopting a dog? YesNo Do you have a doggie door? YesNo If not, and if it would work better, would you consider installing a doggie door? YesNo Do you have a pool? YesNo If yes, is there a separate fence around the pool? YesNo Section 3: Household/Family Number of adults in household? Relationship(s): SpouseRoommate(s)Life PartnerOther Do any children live in the house? YesNo If so, please list their gender/ages? Have your children been around pets before? YESNO Please explain: Do any family members have allergies to animals? YesNo Does anyone in the household smoke indoors? YesNo Do you foresee any major changes in your life in the next 15 years (average lifespan of a dog) such as marriage, childbirth, health problems due to age, going away to college? YesNo If yes, please explain: Can you provide a permanent home for this dog for 10-15 years? YesNo Section 4: Household Pets Number, type and age of pets CURRENTLY in household? How many dogs have you owned in the past? If any, please describe what happened to each of them: Tell me your favorite thing and least favorite thing about your current or past pets: Do any of your current or did any of your past pets live primarily outdoors? YesNo Section 4: Care & Training What is your veterinarian's name and phone number? What do you expect annual pet care (vet care, medication, heartworm preventative, etc.) to cost yearly? Were all previous pets spayed/neutered? YesNo Are all current pets spayed/neutered? YesNo Do you know what heartworm disease is and how to prevent it? YesNo Is your current dog or was your previous dog on heartworm prevention medication? YesNo If yes, how often do/did you give the heartworm medication? What brand do/did you use? How do you plan to prevent fleas and ticks? Who will be responsible for the daily care and training of your new dog? How do you plan to housebreak your new dog? Is the dog you applying for a long haired breed? YesNo If you are considering a long-haired breed, how often would the dog be groomed? Would he get haircuts? YesNo Would you do it yourself? YesNo Have a groomer do it? YesNo Have you ever had a serious behavior problem with a previous dog? YesNo If so, please describe: Have you always kept an ID tag (other than a rabies tag) bearing your phone number on your pets? YesNo Are you willing to keep a collar and ID tag on all of your pets including a new dog at all times? YesNo Under what circumstances do you think it is okay to leave a dog outside alone and unsupervised in an unfenced area? ok alone quiet subdivisionok alone acreageok alone rural areaok alone when trainednot ok to leave outside alone Is your current (or past) dog trained off leash on commands? YesNo What type of food will you feed? something from the grocery storepremium food from a pet supply store Brand name: Section 5: Lifestyle On a typical day, how many hours will the pet be home alone? Please tell us your typical work schedule: When you come home from work, what do you usually prefer to do? (example: watch TV & relax, spend time outside, go for walks, etc), Please explain: Where does your current dog stay when home alone during the day? Where will your new dog stay when home alone during the day? Where do current pets sleep at night? Where will the new dog sleep at night? Will your new pet be allowed on the furniture? YesNo What percentage of time will the dog spend inside the house? % Section 6: Additional Questions What circumstances, in your mind, justify giving a dog up? movingnew babynot getting along with other petsdivorcegetting out of fencebehavioral problemschildren lost interestif it gets too bigtoo time consumingsheddingallergieshousebreaking problemsmedical problemsaggressive behaviorother - please explain If other, please explain: Have you ever given a dog up or had a dog for a brief period of time and it didn't work out? YesNo If so, please explain the circumstances and what happened to it: Have you ever applied for a pet with another rescue group? YESNO If so, how long ago? Did you adopt? Please explain: If you are unable to keep your dog for any reason at any time will you return the dog to us? YesNo If your pet later develops a medical problem that becomes expensive, what would you do? Find another home for himPay whatever it takesHave him put to sleepGive him to a rescue group or shelterother - please explain If other, please explain: If your pet develops a frequent urination problem at the age of 12 and can't hold it when left alone, what would you do? Have him put to sleep since he is olderBabygate him in where flooring is not carpetedGive him to a rescue group or shelterPut in a doggie doorother - please explain If other, please explain: Has a dog or puppy died on your premises in the last 6 months of distemper, parvo or unknown causes? YesNo If you date or marry someone who does not like or want your pets, what would you do? Please list the names, addresses and phone numbers of 2 personal references: How did you hear about Forgotten Paws? websitenewspaperword of mouthradioat an adoption dayother - please specify If other, please specify: Typing your name below will serve as legal signature. By signing below, I am attesting to the truthfulness of my answers.
