What is the name of the dog(s) you are interested in adopting?
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Why are you interested in adopting this dog/these dogs?(*)
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How did you hear about Fancy Cats and Dogs?
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Name(*)
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Address(*)
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Apartment #
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City(*)
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State(*)
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Zip Code(*)
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Home Phone(*)
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Cell Phone
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Work Phone
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Email(*)
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Drivers License State of Issue(*)
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Date of birth(*)
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Date moved in
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Landlord Name
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Landlord Phone
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Employer Name(*)
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Employer Phone
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Spouse's Name
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Does anyone in your household suffer from cat or dog allergies?(*)
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Is everyone in your household aware of and agreed upon adopting a pet?
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Do you
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Renters, please bring a copy of your lease showing you are permitted to have a pet with a receipt that you have paid any required deposit once your application is approved and you are coming to meet and/or adopt a dog.
Homeowners, please bring a copy of a mortgage statement and utility bill once your application is approved and you are coming to meet and/or adopt a dog.
Activity Level
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Household has
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You live with
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List Ages of Children
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Residence Type(*)
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Describe what you are looking for in a dog:
Gender
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Age
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Activity
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Other
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Housing(*)
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Personality and Characteristics(*)
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How frequently do you travel either for business or pleasure?(*)
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What will you do with the dog while you are traveling?
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How many hours per day will your dog be left alone?
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Do you have a dog or cat door that leads outdoors?(*)
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What will you feed the dog?(*)
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Will you walk the dog?
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How many times per day?
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Who will be responsible for feeding the dog?
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Where will your dog live?
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If other, please provide details.
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What pet behaviors would cause you to give up the dog?(*)
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If other, please provide details.
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What changes in your home would cause you to give up the dog?(*)
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If other, please provide details.
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Please list the animals that have shared your home in the past 5 years:
Pet One
Name
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Breed
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Sex
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Age
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Sterilized
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Tested for FIV/FeLV
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Indoor/Outdoor
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Declawed
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How long have you had this pet?
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Still with you (if not, why?)
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Pet Two
Name
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Breed
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Sex
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Age
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Sterilized
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Tested for FIV/FeLV
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Indoor/Outdoor
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Declawed
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How long have you had this pet?
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Still with you (if not, why?)
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Other Pets
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What will you do if the dog doesn’t get along with your current pet(s)?
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How much do you think it costs, per year, to care for a dog?
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What will you do if the cost exceeds this amount?
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Are you prepared to pay for regular grooming?(*)
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Are you prepared financially to cover annual costs for updating shots, spay.neutering and emergency care for your pet?(*)
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Current
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Veterinarian Contact Information (for animals listed above)
Phone
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Prior
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Phone
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Do we have your permission to contact your vet(s) for a reference?
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Have you ever adopted an animal?(*)
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If yes, from where?
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Have you ever surrendered an animal?
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It yes, please elaborate
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Have you ever been cited or convicted of a crime relating to animal cruelty, or do you have a charge pending?(*)
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I will allow a rescue representative to perform a pre-adoption home check.(*)
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I will allow a rescue representative to visit my home later to check on the animal(s) I am adopting.
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I am aware that the adoption fee for the dog/puppy I am considering is non-refundable.(*)
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Signature(*)
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Date(*)
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We do not guarantee the health of any animals offered for adoption. Any time you adopt an animal, you should take it to a licensed veterinarian as soon
as possible. Your animal is, to the best of our knowledge, healthy, but will need to be started immediately on a program of preventative veterinary care.
Please be aware that the animals available for adoption are rescue animals and, as such, have often been exposed to a variety of diseases. Like human
illnesses, these disorders can have an incubation period of up to several weeks. If the animal you adopt shows signs of illness at any point, you must take
it promptly to your veterinarian for treatment at your expense.
I have read and understand this disclaimer.
___________ (initial below)
initial
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By signing this application, I acknowledge
that I have answered all
questions truthfully. failure to provide truthful answers can result in the forfeiture of your adopted pet by Fancy Cats and Dogs Rescue Team.
