Adoption Application Date Thank you for your consideration in adopting an Always & Furever pup! To adopt from A & F, you must: Be 21 years of age or older Have consent from your landlord to have a dog if you rent your home Have all dogs and cats (6 months or older) in the home spayed or neutered, unless there are medical reasons for not doing so Have all dogs in the home up-to-date on vaccinations Agree to have a home visit done by one of our volunteers, if deemed necessary By completing this application and signing below you indicate that you have read, understand and agree to the above. Please fill out the from in it's entirety. It is possible to "Save and Continue" if you do not finish.Contact InformationName* First Last OccupationAddress* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code How long at this address?Daytime PhoneEvening PhoneBest time to call?Email* Enter Email Confirm Email Family & HousingList all Family Members that will be living with the dogNameRelationshipAge Click the "+" sign at the end of the row to add family memberIs anyone in your home allergic to dogs?*YesNoPlease explain why you will still be able to adopt*Is everyone in agreement with the decision to adopt a dog?*YesNoPlease explain why you will still be able to adopt*What type of home do you live in?*Single familyTown homeApartmentFarmDo you...?*OwnRentPlease provide the rules governing pets*Please list landlord information*NamePhone Number By providing this information you are allowing Always & Furever to contact your landlord. Please inform them of this so they will speak with us)Please describe your household:*ActiveNoisyQuietAverageDo you have have time to provide adequate love and attention?*YesNoYou should really re-think adoptionOther PetsDo you currently have pets?*YesNoList your pets*Type of pet (dog, cat...)How many? Are they up-to-date on vaccines?*YesNoExplain why they are not up-to-date on vaccines*Are they spayed/neutered?YesNoExplain why they are not spayed/neutered:*Have you ever surrendered a pet?*YesNoExplain why you had to surrender the pet*Have you ever had a pet euthanized?*YesNoExplain why you had to have the pet euthanized:*Have you ever lost a pet to an accident?*YesNoHow do you discipline your pets and why?*VeterinarianVeterinarianVet's NameClinic NameClinic AddressClinic PhoneProviding Always & Furever with this information you are allowing Always & Furever to call your vet. Please call your vet and ask them to authorize the release of information to Always & Furever.About the Dog You Wish to AdoptWhat is your idea of an ideal dog and why?*Desired Sex*Spayed FemaleNeutered MaleNo preferenceDesired AgeDesired SizeDesired BreedList all breeds you would you not adopt:Check those you are willing to adopt: Select All Outgoing dog Shy dog Dog that needs regular medication Dog that needs training Dog that needs grooming None of these Where will the dog spend the day?*Where will the dog spend the night?*Number of hours (average) the dog will spend alone?*Who will have primary responsibility for this dog's daily care?*Who will have financial responsibility for this dog?*Do you agree to provide regular health care by a licensed veterinarian?*YesNoYou should really re-think adoptionDo you agree to keep the dog as an indoor dog?*YesNoYou should really re-think adoptionWhen the dog goes out, how do you plan to supervise it?*fenced yard?, on a leash?...Do you agree to contact Always & Furever if you can no longer keep this dog?*YesNoYou should really re-think adoptionAre you willing to let a representative of Always & Furever visit your home by appointment, or send photos of your residence?*YesNoAre you willing to let a representative of Always & Furever contact you for updates on the adoption and post pictures online and/or via social media?*YesNoHow did you hear about Always & Furever? (If event, please list!)Personal References*NameAddressPhoneRelationship (relative, neighbor, friend, etc.) Please list at least 2, one family member and one non-family member. Click the "+" sign at the end of the row to add references.All of the information I have given is true and complete. This dog will reside in my home as a pet. I will provide it with quality dog food, plenty of fresh water, indoor shelter, affection, annual physical examination and vaccinations under the supervision of a licensed Veterinarian.WE RESERVE THE RIGHT TO REFUSE ADOPTION TO ANY APPLICANT FOR ANY REASON. THIS QUESTIONNAIRE BECOMES PART OF OUR CONTRACT.Please read carefully, check each box, and sign to indicate agreement.* Select All I understand that a home visit is required prior to final placement I understand that a home visit does not guarantee placement I agree to provide my own collar, leash and a personal ID tag at the time of completing the adoption contract. Signature*NameDate
Adoption Application