Adoption Application | Fuzzy Pawz Rescue

Date

Where did you hear about this animal?

Animal Name/Breed

Applicant Name #1

First Last

Applicant #1 Date of Birth

Applicant Name #2

First Last

Applicant #2 Date of Birth

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Home Phone

Cell Phone

Email (required field)*

Employer and occupation

List all members of your household and ages of any children

Is someone in your home a United States military veteran?

Yes
No

Residence Information

Type of residence

Do you

How long at present address

If renting does your lease allow pets?

Yes
No

Is there a breed or size limitation? If so describe:

If you rent list landlord name and phone number:

Is your yard fenced:

Yes
No

If yes, height/type:

Your Animals

**Note ALL dogs and cats must be spayed/neutered in order to be eligible for adopting.

List all animals in household, including sex, age, breed for each:

Are all animals listed spayed/neutered:

Yes
No

If no explain:

**Note ALL dogs and cats must be spayed/neutered in order to be eligible for adopting.

Are all animals listed vaccinated:

Yes
No

If no explain:

Miscellaneous Information

Does anyone in your household have animal allergies, if so explain:

Are you gone for long periods of timeduring the day when the animal will be left alone and if so where will the animal be kept during that time?

Have you submitted an application to another organization at this time?

Yes
No

Have you ever had an application declined for adoption of an animal? If so why?

Do you understand that this dog may have accidents in the house (even if house trained) the first few days and that a cat may need a few days to find the litter box?

Yes
No

Are you willing to house train a dog, and do you understand that changing a dog’s environment may cause the dog to have accidents?

Yes
No

If a behavioral problem arises, what steps will you take to correct it? Will you consider obedience training for a dog? Or are you willing to talk to your vet about cat issues?

Describe the kinds of personal situations where you might have to return your adopted dog or cat:

Have you considered the extra expenses that will come with adopting this animal; including vet care, food, supplies, toys, training and potential boarding?

Why do you wish to adopt this particular animal?

References

Reference #1

First Last

Phone

Email

Relationship

Reference #2

First Last

Phone

Email

Relationship

Veterinarian

Phone

Signature

I have read the above information carefully and have filled out this application honestly. I understand that omission of information and/or failure to answer all questions and sign the application can result in this application being declined. Also, if an omission or untruth is discovered after an adoption takes place, I understand that Fuzzy Pawz Rescue (FPR) reserves the right to annul the adoption and reclaim the animal. I give FPR permission to fully investigate the information provided as well as contact veterinarians and supplied references. If the application passes this review, I agree to a home and yard visit on a mutually agreed date by a FPR volunteer before an adoption decision is made.nnIn addition, I understand the adoption decision is dependent on many factors, including but not limited to the compatibility of the family and home to the individual animal, and other applications received on this animal. I understand it is FPR's prerogative to decide which home is most appropriate and that their decision is final, and therefore I will not argue with the decision. Unless otherwise indicated by FPR, I am free to apply and undergo the application process in the future.nnI understand that unless the dog/cat was an owner-surrender, age and breed are unknown and are only estimated by the rescue group. nnIf I am selected to adopt the dog/cat listed above I will have to complete a Fuzzy Pawz Rescue adoption contract and will have to pay an adoption fee and vetting costs incurred by Fuzzy Pawz Rescue. I agree that by typing my name in the space provided below and pressing the submit button I have effectively signed this document.

Full Name of Applicant (required)*