09.13.21-Ffdr Adoption Application - Fillable Form For Website
09.13.21-Ffdr Adoption Application - Fillable Form For Website
09.13.21-Ffdr Adoption Application - Fillable Form For Website
Your Information:
Full Name (and Partner, if there is one):
First Name Last Name Age:
First Name Last Name Age:
Email Address(s)
Phone Cell or Alternate Phone
Street Address
City
Province Postal Code
Do you rent or own the above address? Rent Own
Type of Dwelling?
Choices: House, Townhouse, Condo / Apartment, Farm, Other (explain)
Do you have a yard? If so, how large?
Is the yard fenced?
1
How long have you lived at current address?
If you are renting and you have been there under a year, what was your
previous rental history?
How far from your dwelling is the nearest busy road (ie: not a side street)?
If you are renting: Can we contact your landlord if you decide to adopt the
dog?
Landlord's Contact Information (If Applicable)
Name:
Address:
Phone Number:
YOUR FAMILY:
Including yourself, how many people are in your household?
No. of children in the home? What are their ages?
Are the children used to dogs?
Note: Some of our dogs may not be suitable for younger children.
Is everyone in the household in agreement with adopting a dog?
How would you describe your lifestyle?
Choices are: sedate, leisurely, moderately active, very active
How would you describe the pace of your home?
Choices are: quiet, moderately busy with some noise, hectic and very noisy
Does anyone in your family smoke?
Who would be the dog's primary caretaker?
Will all members of the household take part in caretaking?
2
PAST PET OWNERSHIP:
If there are no animals, please write "There are currently no animals at the
proposed residence."
If no animals at this time, have you had any in the past 6 years?
If yes, what happened to them?
Have you ever owned a 'rescued' animal before?
If YES, describe:
REFERENCES:
PROVIDE REFERENCES (THAT DO NOT CURRENTLY LIVE WITH
YOU) AND A MAXIMUM OF TWO FAMILY MEMBERS
REFERENCE 1:
First Name: Last Name:
Contact information (Phone Number):
Relation to yourself:
5
REFERENCE 2:
First Name: Last Name:
Contact information (Phone Number):
Relation to yourself:
REFERENCE 3:
First Name: Last Name:
Contact information (Phone Number):
Relation to yourself:
VETERINARY REFERENCE (If you do not have a vet just put N/A)
Practice Name:
First Name: Last Name:
Contact information (Phone Number):
Signature:
6
GENERAL RULES FOR ADOPTION
1. This animal should always be treated with dignity, kindness and love in a
permanent home.
2. It is expected of you to ensure that this animal always has access to
food, clean drinking water and any medical treatment it may need, as well
as ensure its emotional wellbeing for the rest of its life. It is furthermore re-
quired of you to provide this animal with adequate shelter from any ele-
ments.
3. No animal adopted from FUREVER FREED is allowed to be used as a
guard or security animal at a place of business, sold for medical or experi-
mental purposes, used for breeding or for exhibit or performance purposes,
or for any illegal activities. This animal is meant to be a pet in a loving
home only.
4. Should you for any reason in the future, be unable to keep this animal,
you will return it to FUREVER FREED, where it will be re-homed by our-
selves. Under no circumstances are you allowed to pass this animal on,
sell it, or transfer ownership to anyone else without the written approval of
FUREVER FREED.