First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

Email*

Home Phone

Cell Phone

What Is the name of the dog you are interested in?
Choose an animal: Jake King Ryan

Tell us about yourself, and why you want to adopt this dog? *

How did you hear about this rescue?

Have you applied with any other rescue
Choose one: Yes No

If yes, which rescue did you apply for?

Who will be the primary caretaker of your new dog

Does anyone in your household have allergies or asthma?
Choose one: Yes No

Type Of Residence
Choose one: House Apartment Condo Other

Do you have a yard?
Choose one: Yes No

What size is your yard?

Is the yard completely fenced/closed in?
Choose one: Yes No

What is you fence material and what is the height of your fence?

If you do not have a fence, how do you plan to exercise and keep your new dog safe?

Do you have a pool or live by water?

What precautions do you take when your dog is around water?

Do you have dog doors?
Choose one: Yes No

How many hours per day will dog be alone?
Choose one: 0-2 Hours 2-4 Hours 4-6 Hours 6-8 Hours 8-12 Hours 12+

Where will your dog be kept during the day?

When you are gone where will your dog(s) be kept?

Where will your dog sleep?

Are you willing to house-train a dog?
Choose one: Yes No

Are you willing to go to obedience classes?
Choose one: Yes No

Have you researched different breeds of dogs and what type of breeds do you like? Please describe:

What sex of dog do you want to adopt?
Choose one: Male Female No preference

What is the age of dog you would like to adopt?

Anything Else you would like us to know?

Place of employment

Occupation

Landlord/ Management Company

Landlords Phone Number

Note: If renting,  you will be asked to provide a copy of your lease/co-op bylaws in the next phase of the adoption process. If you live in a condominium/co-op, or your house is a part of a homeowner’s association, please provide a copy of the bylaws, rules and regulations of such association stating that there are no restrictions regarding owning a dog. If there is a limit on the number of pets you are allowed, please note the limit on the copy of the bylaws.                                                              

Please list current pets name, Age and Breed, if spayed/neutered, and what happened to all the animals that you no longer have (last 10 years.)

VETERINARIAN REFERENCES: 
If you currently own a pet or have owned one in the last 10 years, your vet’s name is required to process our application. 

What is Your Veterinarians Name

How long have you been with this Veterinarian?

Veterinarians phone Number

If no Veterinarian’s reference, please provide a reason

PERSONAL REFERENCES: Preferably those who are familiar with your experience as a pet owner. NO family members please.

Reference # 1

Full Name

Primary Phone Number

Reference Email Address

Relationship to reference

Years Known

Reference # 2

Full Name

Primary Phone Number

Relationship to Reference

Years Known

FHR does ask an adoption fee in order to help us cover expenses incurred. Anything received above that amount is a tax-deductible donation. Please contact your local representative if you have any questions. All of the above information I have given is true and complete. Should an unneutered or unspayed dog be placed with me, I agree to have it neutered or spayed by such date agreed upon by me (adopter) and  Furever Home Rescue representative. At that time, I will forward evidence to FHR that such procedure has been completed. 
I further understand and agree that FHR uses my personal information in order to process my application, including distribution of that information as needed to volunteers of FHR by email communication and through posts on a closed, password protected online data management site. FHR makes reasonable commercial efforts to secure my personal information from unauthorized access, use or disclosure. Unfortunately, however, no data transmission over the Internet is 100% secure. While FHR strives to protect my information, FHR cannot ensure or warrant the security of such information. 

All dogs adopted through FHR will reside in a home as a pet only and you agree that you will provide it with adequate food, water, shelter, training, affection, and medical care. I understand that FHR is a referral service and is not responsible for the accuracy of information received about the habits, temperament, or physical condition of dogs available for adoption. I understand that it is my responsibility to evaluate the dog for myself before agreeing to adopt it. I am in full agreement with these terms of adoption. FHR shall not be liable for, and is hereby relieved from, all liability for any damage, expenses, causes of action, fines, suits, demands, judgments or claims of any nature whatsoever arising from or by reason of any damage to property or injury to any persons caused in whole or in part by the dog placed in your home. I hereby accept and assume such liability and agree to protect, indemnify and hold FHR harmless from and against all of the aforesaid. This Includes the meet and greet of the potential Dog.  Submitting this form constitutes your permission for us to check references. 

SUBMISSION: 
There is absolutely no guarantee made or implied that any person requesting to adopt a dog being fostered through FHR, or posted on the FHR website, will receive approval to adopt a dog. Rather, all adoption applications are subject to acceptance based on a review process that may require collecting information from references and visiting the applicant's home. All decisions on placing dogs in adoptive and foster homes are based solely on the judgment of the volunteers and coordinators of FHR. Adoption applications submitted through this form may be denied for various reasons. FHR reserves the right to make all decisions regarding placement or final disposition of any rescued dog in its care whether in, or being placed in, a foster or adoptive home or other facility. 

By typing your name below and clicking the "Submit" button below you attest that you have read the above disclaimer, agree to the terms therein, and are at least (21) years of age. Furthermore you represent that the information you have provided on this form is the truth to the best of your knowledge and belief. By submitting this application you authorize FHR to access your references. 
Thank you for considering a rescued companion! 
(Click the "Submit" button to submit your application) NOTE: Please wait a few moments for the confirmation page before exiting.