Which Dog Are You Interested In

Freedom Farm Animal Sanctuary

Adoption Application

Which dog are you interested in:

Name:Age: Sex:

Description: ID Number:

Tell us about yourself:

First Name: Last Name:

Address:

City: State: Zip Code: County:

Home Phone: Cell Phone: Work Phone:

Email Address:

Driver’s License #/State: / Employer:

Tell us about your home environment:(You must provide this information to adopt from us)

OWN: RENT:

Landlord Name: Landlord Phone:

Landlord’s pet policy:

Ages of children living with you:

Do you have a fenced yard? If yes:

May we visit your home prior to application approval (required for adoption)?

Tell us about your current pets:

Do you already own pets?

If yes, breed and sex:

Are your current pets spayed or neutered?

If no, list reason:

Please list your current animal care provider, or a previously used clinic for the pets you’ve had in the past:

Veterinarian/Clinic Name:

Veterinarian Phone Number:

Tell us about your adoption plans:

What is the reason you’re looking to adopt a dog?

Who will care for, train and exercise the dog?

What is your family’s activity level?

Where will the pet primarily stay?

How longwill the dog be left alone(without human company) on a daily basis?

Where will the dog stay when you are away from the house?

Where will the dog sleep at night?

How long do you feel a dog be should be given for an adjustment period?

Are you willing to work with a new pet on any issues he or she may have?

Does anyone in your house have allergies?

If yes, to what?

Wrap up questions:

Are you aware that routine cost of maintaining a pet averages more than $500 a year?

If you have to move, what will you do with your dog?

Have you ever sold, given away or surrendered a pet to a shelter? If yes, please specify:

Have you, or any member of your family/household, been cited for leash law violations or cruelty to animals in the past? If yes, please explain:

How did you hear about FFAS?:

Signature: Date:

This application does not guarantee that the animal is going home with you today. You must meet FFAS qualifications to complete the adoption. The above signed recognizes the right of FFAS to turn down any application for any reason, and will not hold FFAS responsible for any liabilities involved with the adopted animal. Please note that your signature gives FFAS permission to check references (landlord, veterinarian, etc.) you may have listed to verify information given.