First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

County

Email*

Home Phone

Work Phone
x

Cell Phone

Alt Email

Are you interested in adopting a cat, kitten, dog, other, or no preference?
Choose one: Cat Kitten Dog Other No Preference

If there is a specific animal you wish to adopt, please provide their name.

Describe why you are interested in adopting now.

If the animal you are interested in is no longer available, would you be interested in another Friends for Life animal?
Choose one: Yes No

What are the full names and dates of birth of all adults in the household?

How many children are in the household, and what are the ages of the children in the household?

Do you own or rent your home
Choose one: Rent Own

How long have you been at current address?

if you rent, please provide the name of the complex and your landlord's or property manager or home owner's name and phone number.

Will you be the primary caregiver of the animal, or are you adopting for someone else?
Choose one: Primary caregiver Adopting for someone else

If you currently have pets, please list their names, species, age, sex, and describe their personality.

Have you owned animals in the past? Please share a brief history with them and what happened to them.

Who is your veterinarian? Please provide the clinic name and their phone number. We also ask that you inform your vet to expect a phone call from us.

Describe what you are looking for in your new pet. For example, playful, cuddly, quiet, rambunctious, sassy, etc.

Describe what a typical day looks like for pets in your home including how long they will be left alone.

If applying to adopt a dog, how will you keep the dog confined to your property?

If adopting a cat, how will it be prevented from clawing on the furniture and carpet?

Would you ever consider declawing a cat? if yes, under what circumstances?

Will the cat be allowed outside? If yes, under what circumstances?

Is there anything else you would like to share?

How did you hear about Friends for Life Animal Haven?

Friends For Life Animal Haven reserves the right to conduct a home visit and contact your veterinarian before approving an adoption. if this adoption is approved, follow-up contact will be made to ensure the adoption experience was a success. I certify the information given on this application is true and complete to the best of my knowledge. I also understand that falsified information or significant omissions may disqualify me from further consideration for adoption of a Friends For Life Animal Haven animal. Please write your full name and today's date.*