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ADOPTION APPLICATION
Printable Format

Name and ID of the pet you wish to adopt:
THE BASICS
Your Name
Your Address
City/State/Zip
Your Age:    Phone:    Email: 
 
Highest level of education (please check one)
Did not finish high school
 Attending college		 Attending high school
 College degree		 Graduated high school / GED
 Advanced degree
 
Employment status (please check one)
Not currently working
 Current job 5 yrs. or more		 Current job less than 6 mo.
 Retired		 Current job over 1 yr.
 Homemaker
 
Relationship (please check one)
Single
 Married		 Significant other, living apart
 Widowed/divorced		 Living with significant other
 
LIVING SITUATION
How long at your current address (please check one)
Less than 6 months
 10 years or more		 A year or more More than 5 years
 
How close is your home to a road or other significant source of traffic?
Less than 50 ft.
 Half mile or more		 More than 50, less than 200 ft. More than 200 ft.
 
Are you currently renting? No
(meaning you or member of your family owns your home)
 Yes
(You MUST proved the Landlord's full name and phone below)
   
Are you planning to more? No
Yes
(Does your new place accept pets? Explain below)

 
How many adults live in your household? (please check one)
One
 Four		 Two
 Five or More		 Three
 
How many children live in your household? (please check one)
Zero
 Three		 One
 Four		 Two
 Five or More
 
Do you currently have a fenced in yard? (please check one)
Does not apply, I'm hoping to adopt a cat
 No
 Not Yet, but I plan to build a fence
Yes, 4 ft. high chain link
 Yes, 4 ft. high wood privacy
 Yes, 4 ft. livestock		 Yes, 5 ft. high or more, chain link
 Yes, 5 ft. high or more, wood privacy
 Yes, 5 ft. high or more, livestock 
Yes, Other
 
ADDITIONAL INFORMATION
Would you object to an inspection of the adopted pets proposed living arrangement by a Humane Officer? No Yes
 
Do you currently own any pets? (please check one)
No
 One cat
 Reptile (s)		 One dog
 Two or more cats
 other		 Two or more dogs
 Bird (s)
 
Have you previously owned any pets? (please check one)
No
 One cat
 Reptile (s)		 One dog
 Two or more cats
 other		 Two or more dogs
 Bird (s)
 
Have you adopted a pet from FAHS before?
 No Yes (Who and when? What happened to this animal?)

 
Why do you want this particular pet?

 
Describe any possible circumstances that would prevent you from keeping this pet?

 
Have you ever been convicted of a felony? No Yes (explain below)

 
Your current veterinarian?
Their phone number?

Name of pets that have been seen by this veterinarian?

 
By submitting this application I attest that the information contained herein is accurate and true to the best of my knowledge. I understand that by submitting this application it is not a guarantee of my being able to adopt any animal from FAHS. Furthermore I agree to allow FAHS do a full background investigation. I have read all the pages on this website associated with adoptions and fully understand what I'm getting myself into.

 

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