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Application Form
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Name
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Date:
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Address:
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Home Phone:
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City, State, Zip:
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Cell Phone:
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Email Address:
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Place of employment:
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If leasing, Complex/Landlord Name & Phone:
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Work Phone:
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1. How long have you lived at the above address?
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2. Check one for your current housing:
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House
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Apartment
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Mobile Home
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Condo
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Do you own
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Rent
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Amount of deposit
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Do you foresee moving in the near future?
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Yes
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No
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3. How many people live in your household?
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Adults
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Children
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Ages of children
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4. Do all members know that you plan to adopt a pet?
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Yes
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No
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5. Are you and/or your spouse currently employed?
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Yes
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No
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6. Are you 21 years of age or older?
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Yes
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No
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7. Do you smoke?
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Yes
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No
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In home
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Outside
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8. Do you live with your parent or relatives?
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Yes
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No
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9. Does anyone have pet allergies?
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Yes
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No
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If yes, what kind
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10. For whom are you interested in adopting?
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Self
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Family
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Someone else
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11. Why do you want a pet?
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Companion for self
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Companion for other pet
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Gift
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Childrens pet
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Family pet
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Yard pet
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Guard dog
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Watch dog
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Hunting
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12. If a dog, is being housebroken required?
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Yes
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No
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13. Do you currently have any pets?
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Yes
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No
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Type of pet(s)
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Sex, Age, Breed
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14. Have you had any pets in the past five years?
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Yes
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No
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How many?
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Where are they now?
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15. Has a cat or a dog died on your Premises in the last three months
from FIP, FIV, FELV, distemper, parvo, or unknown causes?
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Yes
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No
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What did he/she die from?
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16. Where do your present pets live?
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Indoor
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outdoor
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17. Where will you new pet live?
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Indoor
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Outdoor
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18. Where will your new pet sleep?
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Indoor
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Outdoor
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Basement
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Garage
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19. How will your pet be exercised?
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Walking
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Running
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Runner chain
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20. Are your gates secured by locks?
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Yes
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No
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21. Is there a completely fenced yard available?
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Yes
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No
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22. How high is the fence?
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What kind of fence?
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23. Are your present pets up to date on their shots, and spayed or neutered?
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Yes
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No
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24. Do you object to spaying or neutering?
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Yes
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No
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25. Vet or Veterinary clinic name & phone number?
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26. What do you think annual preventative veterinary care for a pet would cost?
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27. What do you plan to do with your pet when you go on vacation?
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28. What procedures will you use for destructive behavior?
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29. What would you use for flea & tick prevention?
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30. What would you use for heartworm prevention?
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31. May an authorized Forgotten K9s representative inspect the premises
where the animal will be kept, both before, and after adopton?
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Yes
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No
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32. What kind of pet food do you plan to feed your new pet?
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33. Have you ever taken a pet to a shelter before?
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Yes
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No
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How many?
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Why?
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34. For what reason would you give up a pet?
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Personal reference: name, address, phone:
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Name of pet you are interested in
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Please note: Forgotten K9s, Inc. is an independent, non-profit organization. We will in no way be held responsible
for any adult, minor child, and/or their property during the viewing process. In signing this form, you attest that you
agree to release Forgotten K9s, Inc. and it's representatives from all liability for any injury, or damage that may be
caused by any animal to any person or property in your property while in the adoption area.
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I attest that the above information is accurate.
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Typing your name is the equivalent of a legal signature.
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