Friends for Life LKN Humane Rescue
Pet Adoption Application
Friends4LifeLKN.petfinder.com
Date:Cat Dog Foster Name Number
Animal’s Name:
Please answer ALL questions for application to be processed.Applicant Information(person with whom the animal will live)
Name / Driver’s license number: State:
Address:
City: / State: / Zip:
Telephone Home: / Work: / Cell:
E-mail Address: / Date of Birth:
Number of People in Household: / If children are in the household, please list all ages:
Are you or any member of your family allergic to pets or have asthma?: Yes No / Have you been tested: Yes No
Is smoking allowed inside your home? Yes No Are you aware that pets can be sensitive to smoke? Yes No
If presently employed, list your Employer: / Unemployed Retired Student
Co-Applicant Information(additional person with whom the animal will live)
Name: / Relationship:
Telephone numbers: Home: / Work: / Cell:
E-mail Address: / Date of Birth:
Are you presently: Employed Employer: / Unemployed Retired Student
General Information
Home Owner Yes No Rental Manager: Name/ Number
If rental, are pets allowed?: Yes No / Size Restrictions? Yes No / Max. Pet Size:
Community name/address:
Type of residence:House Apartment Condo Mobile Home / Housing location: Urban Suburb Country/Farm
Do you consider your pet a part of the family? Yes No / Are you aware that a pet is a lifelong commitment? Yes No
Where will pet live? Inside only Outside only Mostly inside Mostly outside
Where will the pet spend nights? Inside Outside
Do you have a fenced yard or secure area? Yes No / If Yes, describe?
Will you allow the pet to run loose? Yes No / If Yes, where?
How many hours per day will the pet be alone? / Where will the pet stay when left alone?
Describe the activity level in your home: / Busy (visits by friends, meetings, children, parties at home)
Noisy (TV, stereo, machinery, tools, children playing, dogs barking)
Moderate (Normal comings and goings)
Quiet (homebodies, few guests)
Other (specify)
In the absence of the primary caregiver, list who will care for the pet? Please list name & telephone:
Under what circumstances would you return the pet to us?
New Job Divorce New Baby Move Illness Other – specify
Are you willing to take responsibility if this pet acquires an illness? Yes No
Are you willing and able to pay the veterinary costs of caring for your new pet? Yes No
Are you willing to take the time to work with a pet if housetraining or socialization is needed? Yes No
Are you planning to declaw the cat? : Yes No
Are you aware of the different methods of declawing and the side effects? Yes No
Past and Current Pet Information
Have you had pets in the last five years? Yes No / If yes, complete the following chart
Name of Pet / Type of Pet / Years Owned? / Spayed/Neutered? / Inside/Outside? / Where is Pet Now?
Yes No / Inside Outside
Yes No / Inside Outside
Yes No / Inside Outside
Current or past name of veterinarian: / Phone:
Personal References
Name: / Relationship:
Phone: / Best time to contact:
Comments:
____I/we have read the above information carefully and have completed this application honestly. I/we understand that omission of information and/or failure to answer all questions and sign the application can result in this application being declined. Also, if an omission/or untruth is discovered after the adoption takes place, I/we understand that Friends for Life LKN reserves the right to terminate the adoption and reclaim the animal. I/we give Friends for Life permission to fully investigate the information provided as well as contact veterinarians and related officials. If the application passes this review, I/we agree to a home and yard visit on a mutually agreed date by a Friends for Life volunteer before an adoption decision is made.
____In addition, I/we understand that this is not the final adoption agreement. The decision of a placement for an animal is dependent on many factors, including but not limited to the compatibility of the family and home to the individual animal, and other applications received on this animal. I/we understand it is Friends for Life’s prerogative to decide which home is most appropriate and that their decision is final and, therefore, I/we will not argue with the decision. Unless otherwise indicated by Friends for Life, I/we am free to apply and undergo the application process in the future.
How did you hear about Friends for Life? / Would you like to become a volunteer? Yes No
Will you consider adopting more than one animal Yes No
Applicant Signature: Co-Applicant
Co-Applicant Signature(if applicable):
FFL Volunteer Signature:
P.O. Box 2175 Cornelius, NC28031-2175 704.606.1337