Frankie's Friends

Copy/paste the below application into an email to FrankiesFriends@hotmail.com Dog Adoption Application Form Which dog are you interested in? Contact Information Full name: Occupation: Address: How long at this address: Daytime Phone: Evening Phone: Best time to call: Email address: Family & Housing How many adults are there in your family (their relationship to you)? How many children (ages)? What type of home do you live in single family, town home, apartment, farm, etc.? Please describe your household: __ Active __ Noisy __ Quiet __ Average If you rent, please give the rules governing pets and the landlord’s name and number: (by providing this information you are allowing FFR to contact your landlord please inform them of this call so they will speak with us) Does anyone in the family have a known allergy to dogs? Is everyone in agreement with the decision to adopt a dog? Do you have time to provide adequate love and attention for the dog you want to adopt? What other pets do you have (specify type and number)? Are these pets up to date on vaccines? Are these pets spayed/neutered? If not..why? Have you every surrendered a pet to a rescue or shelter? If so, why? Have you ever had a pet euthanized? If so, why? Have you ever lost a pet to an accident? How do you discipline your pets and why? Do you have a regular veterinarian? __ Yes __ No Veterinarian’s name: Clinic Name: Clinic Address: Clinic Phone: (Providing FFR with this information you are allowing FFR to call your vet. Please call your vet and ask them to authorize the release of information to FFR.) What is your idea of an ideal dog and why? Desired age: Desired Size: Desired breed: Breed you would not adopt: Desired sex: _ Spayed Female _ Neutered Male _ No preference Willing to adopt: __ outgoing/hyper 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? (describe) Where will the dog spend the night? (describe) Number of hours (average) 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? __ Yes __ No Do you agree to keep the dog as an indoor dog? __Yes __No When the dog goes out, how do you plan to supervise it? Fenced yard? Do you agree to contact FFR if you can no longer keep this dog? __Yes __No Are you be willing to let a representative of FFR visit your home by appointment if necessary? __Yes __No How did you hear about Frankie's Friends Rescue? (FFR) Would you be interested in fostering? __Yes __No __Would like to know more Personal References Please list someone who is familiar with both you and your pets. Name: Address: Phone: Relationship (relative, neighbor, friend, etc.): Name: Address: Phone: Relationship (relative, neighbor, friend, etc.): 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. ___________________________ _________ (Electronic Signature) (Date)