| Your Name: |
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| Your Email Address: |
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| Your Phone Number: |
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| Your Home Address (street address, city, state) |
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| Your Age: |
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| What is the name of the Furry Kid you are interested in: |
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| Why are you interested in this particular Furry Kid? |
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| Do you live in a house or an apartment/townhome: |
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| Do you own or rent: |
Own
Rent |
| If you rent, please state your landlord's name and phone number: |
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| Do you have a fenced in yard and if so, how tall and what type is the fence? |
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| Are you looking for a primarily indoor or outdoor dog? |
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| How long have you been condering adopting a dog and for what reasons? |
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| If you live outside the KC area, why are you applying for this particular pet? |
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| Have you applied to any other rescues before? If yes, please list them as it may expedite the processing of your application |
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| What is your home environment like (i.e. are you married and do you have children and if so, what are their ages? |
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| Where will your new pet reside during the day? During the night? |
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| What is your work schedule like and how many hours are you gone withing a day? What arrangements would you make for the dog's care when you are at work or away from home for several hours at a time? |
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| Do you travel frequently and what kind of arrangements would you make for your dog while you are gone? |
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| Do you currently have other pets? Please include a description including the breed, sex and age and if they are spayed/neutered. |
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| Have you previously had other pets and what happened to them? Please explain. |
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| Have you ever given a pet away, put up for adoption, taken to a dog pound or shelter or put one to sleep? If yes to any of these, please explain. |
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| What made you decide you wanted to adopt a dog? |
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| How long do you plan to keep your new pet? |
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| Have you ever raised a young puppy before? Please explain. |
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| What are your philosophies on correcting/disciplining a dog for bad behavior? In your opinion, what is the best method to train a dog and have you ever or would you consider attending obedience classes? |
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| Do you have experience/knowledge on the proper way to train an adult dog or a puppy and please explain? |
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| How do you plan to provide regular exercise for the dog? |
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| What are your feelings about tethering a dog in the back yard or anywhere else? |
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| Do you have any experience regarding dogs with special medical or emotional needs? |
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| Are you familiar with heartworm prevention and if so, what kind do you use? |
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| Are you aware of and willing to incur the expense of basic veterinary care for a dog;
i.e., annual vaccinations, heartworm preventative, flea and tick preventative, regular
grooming, or any other veterinary care recommended by a licensed veterinarian? How
would you deal with a situation where your dog needed very expensive medical
treatment? |
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| How much do you anticipate spending annually on your new pet? |
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| Who is your veterinarian? Please provide name and phone number for reference. |
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| Please provide at least 2 personal references with name and phone numbers. |
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| By initialling here, I authorize my veterinarian to release confidential information about my pets to Furry Kids Refuge |
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| Are you willing to allow a home visit for this adoption? |
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| Please tell us anything else about you and your family that you think we would like to
know. |
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By signing below I certify I am at least 21 years of age and that all of the above information is truthful. I understand and agree that Furry Kids Refuge has my permission to contact and verify any of the information I provided.
Applicant (s) Signature, and Date |
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Thank you for your interest in Furry Kids and for taking the time to fill out our on-line
adoption application. We will call or email you as soon as possible! |
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DOG ADOPTION APPLICATION 
