Canine Adoption Application

"*" indicates required fields

Date*

MM slash DD slash YYYY

Specific canine(s) interested in

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Name*

First Last

Email*

Home Phone

Work Phone

Cell Phone

Address*

Street Address Address Line 2 City State ZIP Code

Is the above address where the adopted animal would be living?*

Yes

Employer*

Your place of employment. Please enter "Retired" if you are retired.

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How did you hear about us?

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Have you ever applied to adopt through ARFP?*

Yes

Have you ever applied to adopt through another animal adoption organization?*

Yes

Please provide the name of that organization.

Please provide the names of any other organizations you have applied to adopt an animal from.

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If you're interested in a puppy, what size do you want the dog to be when it is an adult?

Small (Less than 25 lbs)

Medium (26-50 lbs)

Large (51 lbs plus)

What qualities are you looking for in your dog?*

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Why do you want a new pet?*

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Do you currently have any pets that live with you?*

Yes

What pets currently live with you?

Please list all pets currently living with you. Please list one pet per line. Include the pet's name, species, age, and any health issues he or she has.

Have you had pets before?*

Dog(s)

Cat(s)

Other

I have not had any pets before.

What happened to any previous pets that you owned by do not have now?*

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What kinds of problems did you have with any of your previous dogs?*

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What did you do about these problems?*

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If you have ever had a dog lost, stolen, disappear, or die at an EARLY age, please provide the details.

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Have you ever given away or surrendered a dog?*

Given away

Surrendered

Neither

What is your past and intended Veterinarian?*

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Are all the pets living with you:*

Up to date on their shots

Spayed or Neutered

Dogs on heartworm preventative

None of the above

Are your current dogs:*

Please select the option that best describes your current situation.

Primarily indoor

Primarily outdoor

Indoor/outdoor

Will your new dog be:*

Primarily indoor

Primarily outdoor

Indoor/outdoor

What is your reason for this?*

Please explain why you have decided to keep your new dog primarily indoor, primarily outdoor, or indoor/outdoor.

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Where will the dog be kept during the day?*

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Where will the dog be kept during the night?*

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Where will the dog be kept during routine absences?*

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Will you be crating the dog you want to adopt?*

Yes

Is anyone home during the day?*

Yes

When is someone home?*

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Can they handle the dog you want to adopt?*

Yes

Other

Do you live in a:*

House

Apartment

Condo

Mobile Home

Do you rent your home?*

Yes

Whom do you rent from?*

Please provide both a name and contact number.

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Do you have a fenced yard?*

Yes

Is your fence attached to your house?*

Yes

What kind of fence do you have?*

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How high is your fence?*

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Do you have a:*

Please select all that apply.

pet door?

kennel run?

tie-out stake?

dog house?

crate?

None of the above

Do you have outside shelter for this pet?*

Yes

What kind?*

Please describe the outside shelter that you have.

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List all household members (including yourself)*

Please list all household members, including yourself. Give name, age, and whether the person agrees with adopting a new pet.

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If you have children, have they ever lived with dogs?*

Yes

Don't have children

Do any members of your family have allergies to animals?*

Yes

Who will care for this puppy/dog while you are on vacation?*

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Do you understand that this puppy/dog may not be housebroken, and are you willing to take the time to work with it?*

Yes

How much time are you willing to give your new pet to adjust to his/her new home?*

1 week

1 month

Are you agreeable to home delivery?*

Yes

Check any of the following you feel are valid reasons for giving away a pet.*

Please check all that apply.

Fleas

Sheds too much

Chews or destroys household objects

Too expensive

Moving to another state

Children will no longer take care of it

Having a baby

Getting married or divorced

Found a new place to live but they don't allow pets

None of the above

The following is the approximate cost of medical care for a canine. Please keep in mind that the vaccinations must be given yearly in order to keep this pet healthy.

Final puppy distemper/parvo vaccine $45.00
Yearly Wellness Exam $47.00
Yearly adult DHLP-Parvo vaccine $51.25
Rabies vaccine $25.00
Heartworm preventative $100.00-120.00 per year (depending on weight of dog and type of preventative used)

An ARFP representative will contact you regarding this application. There is a 48-hour processing time for this application AFTER THE REPRESENTATIVE SPEAKS WITH YOU. Your veterinarian will be called for a reference and if you rent your landlord will also be called to make sure a pet is permissible. Thank you very much for your patience with us while we ensure that each of these animals applied for is going to a responsible pet owner.

Because the Animal Rescue and Foster Program is trying to find the best match for our foster animals, we reserve the right to turn down any potential applicants.

Certification*

I certify that I have answered all questions honestly and to the best of my ability. I understand that any misrepresentations of fact may result in removal of the adopted pet from my home.

This field is for validation purposes and should be left unchanged.