Dog Name
*
Name
*
First Name
Last Name
Age
*
Phone
*
(###)
###
####
Email
*
Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Occupation
*
Please provide one non-family references (name, e-mail address & phone #):
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Where will your animal(s) mainly be kept? (Inside your home, kennel, garage, fenced yard, etc)
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These dog(s) will be
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Indoor Only
Outdoor Only
Indoor & Outdoor
Is there an outside fenced area for your dog?
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Yes
No
Will you have dog(s) tied up?
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Yes
No
Current animals in your household?
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Are these pets spayed/neutered?
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Yes
No
How many hours per day on average will the pet be left alone?
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Name and phone number of Current Veterinarian:
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Do we have permission to contact and inquire about your current and previous animals with your vet? Yes No
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Yes
No
Type of Dwelling
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House
Apartment
Mobile Home
Condo
Farm
Do you
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Own
Rent
Live w/Parent/Guardian
Please list landlord's name and phone number (if applicable)*If you RENT, you must leave landlord's name & phone number
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Are there children in your household or ones who make regular visits to your home?
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Yes
No
Have they been around dogs?
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Yes
No
Do you have a problem with us doing a follow up call or visit?
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Yes
No
Do all adults in your household know you plan to adopt?
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Yes
No
Who will be primarily responsible for the dog's care?
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What are the qualities you are looking for in a dog(s)?
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Under what conditions would you not keep your new pet?
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Do you understand that if ANY of the information on this application is found to be false, or if we find the animal you are adopting from us is not being given the proper care (personal or veterinarian), we WILL reclaim the animal?
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Yes
No
Have you or anyone that visits/resides in your home ever been accused or convicted of animal abuse or neglect?
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Yes
No
I certify that the information I have supplied above is true and that any false statements may result in nullifying this adoption care application. I further understand that this application is the property of Figz Dog Rescue and will be retained by them. Please remember these dogs were stray or abandoned. We guess on their breed. We do not know their heritage. A rescued dog is forever grateful for being a loved part of your family. Although all of our animals are thoroughly evaluated, we cannot guarantee their health or temperament.
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