Furever Safe Adoption Application
Application to adopt a dog.
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Name of Dog(s) applying for: *
Applicant's Name: *
Home Phone: *
Work Phone: *
Address *
City *
State: *
Zip: *
Email Address *
List Types of Pets Owned in the past three years (Type, Sex, Age, Altered?, What happened to it?.
Vet Reference, Name and Address
Why do you want to adopt a dog? *
Number of Adults in your family/household?
Ages of Children under 18:
Does any family member have allergies to any animals?
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Who will be responsible for this animal?
Do you understand that some dogs may not be housebroken and that changing the environment of the dog may cause the dog to have accidents and/or destroy household items?
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Are you willing to housebreak and train the dog?
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If a disciplinary or behavioral problem arises with the dog what steps will you take to work on it?
How many hours will this dog be alone per day?
Do you live in a:
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Do you:
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Do you?
If you rent, can you get written permission to have a dog?
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Are you familiar with local animal ordinances?
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Where will this pet be kept during the day?
Do you plan to chain the dog outside at any time? If yes please explain.
Do you have a fenced yard?
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What type of fence? Height?
When you go on vacation who will care for the dog?
If you move do you plan to take this dog with you?
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What will it cost to care for, vaccinate and license this dog each year?
Your Occupations?
Are you:
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Please provide 3 personal references: *
How did you hear about us?
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