DOG ADOPTION APPLICATION

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 people reside in your home?

Please provide each person's name, age and relationship to you. Please include any children residing in the 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 (on what floor)
• Condo (on what floor)
• Mobile Home
• Other:

Please describe the number and layout of any stairs in your home.

Do you own or rent your home?

Please describe your fence (material, height):

APPLICANT:

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

How many animals currently live in your household?

For each pet above that is deceased, please tell us:

1) from what they passed,

2) their age when they passed, and

3) in what year they passed.

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

• Yes
• No
• Do not Know

Have each of your pets, both past and present, been kept current on vaccinations?

• Yes
• No
• Do not Know

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 list the name and contact information for your current veterinarian and all veterinarians you have used in the past. Also include which animals were seen by each vet.

Name and phone number of current veterinarian and name of animals seen by this veterinarian:

Name and phone number of previous veterinarians and name of animals seen by each veterinarian:

If your application is processed, you will need to contact each of these veterinarians and give them permission to speak with a FOHA representative.

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

For each pet above that is deceased, please tell us:

1) from what they passed (illness, disease, accident, etc.),

2) their age when they passed, and

3) in what year they passed.

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

• Yes
• No
• Do not Know

Have each of your pets, both past and present, been kept current on vaccinations?

• Yes
• No
• Do not Know

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 list the name and contact information for your current veterinarian and all veterinarians you have used in the past. Also include which animals were seen by each vet.

Name and phone number of current veterinarianand name of animal(s) seen by this veterinarian:

Name and phone number of previous veterinarians and name(s) of animal(s) seen by each veterinarian:

If your application is processed, you will need to contact each of these veterinarians and give them permission to speak with a FOHA representative.

Please list the contact information for any veterinarian you have used and which pets were seen at each veterinarian. If this will be your first pet, please leave this section blank.

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
• e-collar
• Other:

PROVIDING FOR THE NEW DOG:

Please describe where the dog will be kept when you are home?

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

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

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

Please describe where the dog will sleep?

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

Is someone home during the day? If yes, please tell us who? If no, please answer N/A.

How many hours each day will the dog be without human companionship? Please list number of hours and explain circumstances.

Do you have a dog door?

• Yes
• No

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

Most of our dogs are not 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?

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?