DOG ADOPTION APPLICATION

Are you interested in a specific dog or dogs? If yes, please list the name(s) here. If no, please leave blank.

Has everyone living in your home already met this dog?

Where did you hear about FOHA?

Has someone already contacted you in response to your application? If yes, who did you speak to?

Do you live within our adoption area?

APPLICANT INFORMATION:

First Name:

Middle Name:

Last Name:

Street Address:

City: State: Zip:

What is the nearest major intersection to your home?

and

How long have you lived at your current address?

Home Phone:

Work Phone:

Employer:

Cell Phone:

Email:

Age:

If we have questions on your application and need to contact you by phone, what is the best contact number and best time to reach you?

First Name:

Middle Name:

Last Name:

Street Address (if different than above):

City: State: Zip:

Home Phone:

Work Phone:

Employer:

Cell Phone:

Email:

Age:

What is your relationship to the Applicant?

How many persons, including children, reside in your home?

Please provide the following information for EACH person living in your home

Does everyone living in your home know about and agree with your decision to adopt a dog? If not, why not?

Does anyone in your home have a dog allergy? If yes, what precautions are taken?

In what style home do you live?

• Single Family Home
• Townhouse
• Apartment
• Condo
• Mobile Home
• Other:

What is the name of the development or neighborhood in which you live?

Do you own or rent your home?

Do you have any breed or weight restrictions where you live? If yes, what are they? Please note that the home visitor will need to see a copy of your lease at the home visit.

Please describe your fence. How tall is it? What is it made from?

APPLICANT:

Will this be the first dog you have had on your own?

• Yes
• No

If any of the pets above are no longer living with you, please tell us where they are now and include in your answer the information below.

Are there other animals that live in your home that belong to someone else (roommate, tennant, etc.)?

If yes, what is the species (cat, dog, etc.) of the animal, as well as the breed, weight, sex and age?

How many animals total currently live in your household?

Have each of your pets, both past and present, been spayed or neutered?

• Yes
• No
• Do not Know

If not, why?

Have each of your pets (cats and dogs), both past and present, been kept current on vaccinations? Please be advised that FOHA will confirm this information with the veterinarian.

• Yes
• No
• Do not Know

If not, why?

Have you ever surrendered a pet to a shelter?

• Yes
• No

If yes, why did you have to give up your pet? What was the name of the shelter where you took the pet and where is it located? In what year did this happen?

Have you ever given a pet away?

• Yes
• No

If yes, why did you have to give up your pet? To whom was your pet given? In what year did this happen?

Have you ever had to have one of your pets euthanized?

• Yes
• No

If yes, what were the circumstances?

Please tell us the name and contact information for the vet(s) you use or have used for your animals. If you have/had more than one vet, please include which animals are seen by each vet.

Current Animals and contact information for treating vet:

Previous animals and contact information for treating vet:

CO-APPLICANT:  

Unless you plan to be the sole adopter of your new pet, the co-applicant's past pet experience must be included on this application. All other questions must be answered jointly.

Will this be the first dog as an adult? Please do not include dogs you had as a child or that are/were family dogs.

• Yes
• No

CURRENT AND PAST PETS: Please tell us about all the pets you have owned, including those currently living in your home. If APPLICANT and CO-APPLICANT'S history are the same, please state so.

Pets:

Pet 1:

Pet 2:

Pet 3:

Pet 4:

Pet 5:

Pet 6:

Pet 7:

Pet 8:

If any of the pets above are no longer living with you, please tell us where they are now and include in your answer the information below.

> If a pet is deceased, please include when they died and from what.

> If you gave away or surrendered a pet to a shelter, please explain the circumstances that forced you to give up your pet, to whom you gave it (include shelter's name and location, if applicable) and when.

Have each of your pets, both past and present, been spayed or neutered?

• Yes
• No
• Do not Know

If no, what were the circumstances.

Have each of your pets, both past and present, been kept current on vaccinations? Please be advised that FOHA will confirm this information with the veterinarian.

• Yes
• No
• Do not Know

If no, what were the circumstances?

Have you ever surrendered a pet to a shelter?

• Yes
• No

If yes, why did you have to give up your pet? What was the name of the shelter where you took the pet and where is it located? In what year did this happen?

Have you ever given a pet away?

• Yes
• No

If yes, why did you have to give up your pet? To whom was your pet given? In what year did this happen?

Have you ever had to have one of your pets euthanized?

• Yes
• No

If yes, what were the circumstances:

Please tell us the name and contact information for the vet(s) you use or have used for your animals. If you have/had more than one vet, please include which animals are seen by each vet.

Current Animals and contact information for treating vet:

Previous animals and contact information for treating vet:

WHAT ARE YOU LOOKING FOR IN A NEW DOG?

Why do you want to adopt a dog?

• Companion
• Hunting
• Breeding
• Protection
• Alert
• Gift
• Other:

What type of dog are you looking for?

• playful and energetic
• laid back and calm
• independent
• affectionate
• confident
• good with kids
• good with other dogs
• good with cats

If you have a cat, has your cat interacted or lived with a dog before?

• Yes
• No
• N/A

Please describe in detail what you are looking for in a dog?

Are there any behaviors you won't tolerate in your new dog?

What methods will you use to discourage or prevent inappropriate behaviors in the dog?

What methods will you use to encourage and reinforce appropriate behaviors in the dog?

Many dogs require leash training. What method of training will you provide to teach your dog leash manners?

• training class
• halti head harness
• prong collar
• gentle leader harness
• choke collar
• electric shock collar
• Other:

PROVIDING FOR THE NEW DOG:

Where will the dog be kept when you are home?

• outside
• in a doghouse outside
• in a crate
• in the garage
• in the unfinished basement
• in the finished basement
• free run of the home
• Other:

If you chose "in a crate" above, please tell us your plan for crating while you are home, including how many hours the dog will be crated while you are home. Will the dog have a break during this time?

Where will the dog be kept while you are out of the home?

• outside
• in a doghouse outside
• in a crate
• in the garage
• in the unfinished basement
• in the finished basement
• free run of the home
• Other:

If you chose "in a crate" above, please tell us your plan for crating while you are out. Will the dog have a break during this time?

Please describe where the dog will sleep.

• outside
• in a doghouse outside
• in a crate
• in the garage
• in the unfinished basement
• in the finished basement
• free run of the home
• Other:

If you chose "in a crate" above, please tell us your plan for crating at night. Will the dog have a break during this time?

During what hours does your job or other commitment keep you away from home each day, including commuting time?

Do you have a dog door?

• Yes
• No

How will you provide for the dog to get outside while you are gone?

We cannot guarantee our dogs are housetrained. What method will you use to housetrain your new dog?

Are there times when the dog will be tied up?

• Yes
• No

If yes, please explain:

Will the dog spend any time in the garage?

• Yes
• No

If yes, please explain:

Do you drive a pickup truck with an open bed?

• Yes
• No

If yes, will the dog be allowed to ride in the back?

• Yes
• No

If yes, please explain:

Who will provide the daily exercise for the dog?

What type of exercise will you provide for the dog and how often? Please describe your daily exercise routine in detail. How many walks a day?

Will you keep the dog up-to-date on vaccinations and heartworm preventative?

• Yes
• No

If you go away for a few days, or on a vacation, who will take care of the dog?

If you move, what will happen to the dog?

Prior to this application, have you ever applied to FOHA to adopt an animal?

• Yes
• No

What was the result of your application? [If you adopted a companion from us, please include the animal's name while at FOHA and the year you adopted.]

Have you ever surrendered n animal to FOHA?

• Yes
• No

If yes, please explain in detail:

Are you willing to have a FOHA representative come to see where the dog will be living?

• Yes
• No

If no, why not?

Adopting a dog is a life-changing lifetime commitment. Are you ready to take responsibility of this dog for the rest of its life, which could be 10 to 15 years or longer?

• Yes
• No

If no, what is your plan for the dog?

Are you currently working with any other shelters or rescues to adopt a dog? If yes, which ones?

Additional Comments?

FRIENDS OF HOMELESS ANIMALS RESERVES THE RIGHT
TO REFUSE PLACEMENT OF ANY ANIMAL FOR ANY REASON.