Funds for Furry Friends Adoption Application Form

Funds for Furry Friends Adoption Application Form
Pet Information
I am adopting a*
Name of Pet I am Applying for*
Applicant Information
Name*

PrefixFirst NameLast Name
Co-Applicant, if applicable

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail*
example@example.com
Phone Number*

Area CodePhone Number
This Number is*
When is the best time to call?*
Alternative Phone Number*

Area CodePhone Number
This Number is*
If you selected Other, please describe
Do you live in a*
If you selected "other", please explain?
Do you*
If you selected "other", please explain?
How long at current address?*
Landlord Information (if applicable)

*PLEASE NOTE THAT IF YOU RENTING YOU MUST COMPLETE THIS SECTION
Landlord's Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number

Area CodePhone Number
Household Information
Names and ages of ALL Adults in the home*
Number and age of Children in the home*
Ages of Children*
Do you, or anyone in the home have allergies? If yes, please explain how you will manage allergies with your new pet?*
Who will be primarily responsible for the care of the pet? This includes: feeding, grooming, training and exercise.*
Why would you like to adopt from us? (Check all that apply)*

CompanionCompanion for a PetFor a ChildAs a Guard DogOther
If "other", please explain
How many pets do you own now? *
Dogs
Is the dog mainly
Cats
Is the cat mainly
Other
Pet Names
Type/Breed
Age(s)
Sex(es)
Spayed/Neutered?*
If "no" please explain reason.
Where did you get your pet(s) from?*
Are your current pets up to date with their vaccinations?*

YesNoNot Applicable
Please identify any former pets from the past 10 years and the reason they are no longer with you.*
What Veterinarian(s) would have your past/present records?*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*

Area CodePhone Number
Please list any other past vet clinic(s) if there is more than the one listed above:
Which Veterinarian(s) do you plan to use in the future or if you are a first time pet owner?*
Have you ever had to re-home or return a dog/cat? if so, why?*
Do you have any plans to move in the near future?*
If you were to move, what will you do with your pet(s)?*
Please describe how a typical day will go for your new pet. (walks, exercise, alone time, etc.)*
How many hours per day will your pet be alone without human companionship? (please include if this includes a lunch/supper break through the day)*
How many days of the week?*
Where will the dog/cat be kept when home alone?*
Where will the dog/cat be kept when home overnight?*
How and where will the dog/cat receive their exercise?*
How often?*
Do you have a fully fenced yard?*
What is the height of your fence, if applicable? *
If you selected "no" or "other", please describe what outdoor time would look like for the dog (ie. dog run, tether, loose, etc.) ?
Will this dog/cat primarily be*
How will you deal with unwanted behaviour in your dog/cat?*
A dog/cat can live well over 10 years and requires a major commitment of time, finances and emotion. Why do you feel you can make this kind of commitment at this time?*
For dogs: Weight/size of dog as adult are you looking for?
What type of issues/concerns are you NOT willing to work through with a dog or cat?*

Aggressive towards pets (dogs, cats)Aggressive towards kidsAggressive towards livestockExcessive vocalization (barking, meowing, whining, etc)Digging in yard/landscaping/garden areaShedding (dogs or cats)Scratching/clawing furniture (cats only)Housetraining delaysLitterbox issues (cats only)Chewing behaviours (furniture, shoes, etc)Separation anxiety
Please describe any other issues or concerns that would be a "deal breaker"...
Where did you hear about Funds for Furry Friends?*
Please explain.*
Are you aware we are based in Brandon MB, and a visit with the adoptable would take place in Brandon, or surrounding area?*

YesNo
References

Please include 2 references (with at least one being a NON-FAMILY reference) who has known you for a minimum of 2 years.
Reference #1
Name*

First NameLast Name
Relationship*
How long have you known this person?*
Phone Number*

Area CodePhone Number
Alternate Phone Number

Area CodePhone Number
Reference #2
Name*

First NameLast Name
Relationship*
How long have you known this person?*
Phone Number*

Area CodePhone Number
Alternate Phone Number

Area CodePhone Number
Any additional information you would like us to know?
If applicable, please ensure that consent will be forwarded to any applicable vet clinic(s) that will have records for the pets you've owned over the past 10 years. If necessary, there is a downloadable Veterinarian Consent Form that you can print and forward to your vet clinic(s) found on our website on the same page as our Adoption Application. Some clinics will accept a verbal consent, please make sure to call your vet clinic(s) as soon as possible since delays in doing so will affect the timely processing of your application.
Please check....*

I will call my vet clinic(s) to give consent for Funds for Furry Friends to conduct a vet reference as soon as possible!Not applicable
Should be Empty:

Funds for Furry Friends Adoption Application Form

Pet Information

Applicant Information

Landlord Information (if applicable)

Household Information

References