Your Name:
Your Email Address:
Your Phone Number:
Your Street address
Your City, State, and ZipCode
Your Age:
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What is the name of the Furry Kid you are interested in:
Why are you interested in this particular Furry Kid?
Do you live in a house or an apartment/townhome:
Do you own or rent:
If you rent, please state your landlord's name and phone number:
Do you have a fenced in yard and if so, how tall and what type is the fence?
Are you looking for a primarily indoor or outdoor dog?
How long have you been condering adopting a dog and for what reasons?
If you live outside the KC area, why are you applying for this particular pet?
Have you applied to any other rescues before? If yes, please list them as it may expedite the processing of your application
Please list names and ages of all people residing in your home:
Where will your new pet reside during the day? During the night?
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?
Do you travel frequently and what kind of arrangements would you make for your dog while you are gone?
Do you currently have other pets? Please include a description including their name, breed, sex and age and if they are spayed/neutered.
If you have other pets, do they reside inside or outside?
Have you previously had other pets and what happened to them? Please explain.
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.
What made you decide you wanted to adopt a dog?
How long do you plan to keep your new pet?
Have you ever raised a young puppy before? Please explain.
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?
Do you have experience/knowledge on the proper way to train an adult dog or a puppy and please explain?
How do you plan to provide regular exercise for the dog?
What are your feelings about tethering a dog in the back yard or anywhere else?
Do you have any experience regarding dogs with special medical or emotional needs?
Are you familiar with heartworm prevention and if so, what kind do you use?
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?
How much do you anticipate spending annually on your new pet?
Please provide name and phone number of your veterinarian? (for current or past pets )
Please provide at least 2 personal references with name and phone numbers.
By initialling here, I authorize my veterinarian to release confidential information about my pets to Furry Kids Refuge
Are you willing to allow a home visit for this adoption?
Please tell us anything else about you and your family that you think we would like to
know.
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
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! We are a non-profit organization comprised of non-paid volunteers who have jobs and families just like you. Please be patient with us...:-)
DOG ADOPTION APPLICATION 
