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Dog Online Application

Information About You

Name of Dog Interested In/Breed:

Your Name:

Cell Phone:

Home Phone:

Address:

Address 2:

City: (Northern California Only)

State: California

Zip Code:

Email:

Basic Information

How did you hear about Furry Friends Rescue?

Why do you want to adopt a dog?

How many years of experience do you have as a dog guardian?

What type or breed of dog are you interested in?

Sex? Male Female

Age range?

Color?

Hair type?

Activity level? Low Medium High

Type of activity?

Size?

Toy (< 10 lbs)

Small (11-25 lbs)

Medium (26-50 lbs)

Large (51+ lbs)

Where would the dog stay during the day? Indoors Outdoors Indoors/Outdoors

Do you have an enclosed yard attached to your home? Yes No

How tall is your fence?

Do you have a pool? Yes No

Where will your dog sleep? Which room?

How long will the dog be left home alone without human supervision?

If gone too long for a dog's bathroom needs, can you go home mid-day to take the dog out?

Where will he/she stay?

Who will be primarily responsible for the dog's care?

Do all members of your household want a dog? Yes No

If no, please explain.

Do you know that dogs should get yearly vet exams? Yes No

How many days per week will you walk your dog? For how long/distance?

Your Walk speed: Slow, Moderate or Fast pace?

Do you plan to jog with your dog?

If need, will you take your dog to Doggie Day Care, Dog Parks or Socials?

Any special activity?

Are you planning to obedience train your dog? Yes No

Have you taken any dog training classes before? Yes No

If so, name of school or trainer?

What will you do if your dog develops behavior problems?

Do you have a vet? Yes No

If so, may we contact them for reference? Yes No

Vet Name:

Vet Phone:

Vet Address:

Vet City:

Vet State: California

Vet Zip Code:

Do you understand that you will be sharing your life with a dog for 14-18 years, who is totally dependent on you for food, shelter, health, and veterinary care? Are you willing to make this long term commitment to a dog as a family member? Yes No

What would you do if you were no longer able to care for this pet?

Family Information

List names and ages of all people living in the home, including yourself.

Name	Age

Has your child lived with a dog in your home before? Yes No

Do you have children visiting? Yes No

If so, how often?

Ages of children:

If you have pets currently, please list them below.

Type of Animal	Age	Sex	Spayed/ Neutered	Indoor/Outdoor	Size (weight)	Breed
		Male Female	Yes No	Indoor Outdoor Both
		Male Female	Yes No	Indoor Outdoor Both
		Male Female	Yes No	Indoor Outdoor Both
		Male Female	Yes No	Indoor Outdoor Both
		Male Female	Yes No	Indoor Outdoor Both

What brand of food do you feed them?

If you have a cat, has your cat lived with a dog in your home before? Yes No

Please list all the animals you have had in the past 10 years that are NOT LISTED ABOVE.

Type of Animal	Age	Sex	Spayed/ Neutered	Indoor/Outdoor	What happened?
		Male Female	Yes No	Indoor Outdoor Both
		Male Female	Yes No	Indoor Outdoor Both
		Male Female	Yes No	Indoor Outdoor Both
		Male Female	Yes No	Indoor Outdoor Both
		Male Female	Yes No	Indoor Outdoor Both

If no pets in the last 5 years, have you lived with a dog before? Yes No

When?

Do you live in a Apartment Condo House Townhouse

If apartment, which floor?

Do you rent or own? Rent Own

If you are renting, we require a signed note from your landlord/property manager that it is OK for you to have this dog.

If renting - landlord name:

If renting - landlord phone:

Would you agree to a home visit to ensure that it is secure for the pet? Yes, I agree to a home visit. No, I do not agree to a home visit.

PLEASE READ AND CERTIFY THE FOLLOWING

I certify that I am an adult (18 yrs & over) and primary home owner/renter. That all information in this application is true, and I understand that false information will void this application. I agree that upon adopting a pet from Furry Friends Rescue, I will agree and abide by their Adoption Agreement. Please read our FFR "How to Adopt"

Yes, I certify that this is true.

Notes/Special Instructions for Furry Friends Rescue:

Please note: A volunteer will contact you within 72 hours if the dog is available and a match.

If everything looks OK press the Submit button.

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