Forever Home Rescue New England Adoption Application
1. Name of dog you are interested in:
2. Name of second choice dog:
3. Applicant first and last name:
*
First Name
Last Name
4. Co-applicant first and last name:
First Name
Last Name
5. Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curacao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
6. Home Phone
7. Have you adopted from us before?
8. Have you been approved by another dog rescue, and if so, which?
APPLICANT'S INFORMATION
9. Age
10. Gender
male
female
11. Cell Number
-
Area Code
Phone Number
12. E-mail
*
13. Employer:
14. Town/City of Employment:
15. Work Phone #:
-
Area Code
Phone Number
16. Position:
17. Work hours per day including Commute:
Co-Applicant Information
18. Age
19. Gender:
male
female
20. Cell Number
-
Area Code
Phone Number
21. Email Address:
22. Employer:
23. Town/City of Employment:
24. Work Phone #:
-
Area Code
Phone Number
25. Position:
26. Work Hours / day including commute:
About Your Home
27. Type of Residence:
Please Select
House
Apartment
Condo
Mobile
28. Do you:
Please Select
Own
Rent
Live with parents
Other
29. if other:
30. If you rent, landlord's name:
31. Landlord's Phone #:
-
Area Code
Phone Number
32. Landlord's Email:
33. Do you have a fenced yard?
yes
no
34. Is it enclosed?
yes
no
35. If yes, type of fence:
36. Sq. Ft.:
37. Height:
38. If no, would you be willing to have one installed?
yes
no
39. if no, why not?
40. If no, how will you keep your dog safe?
ABOUT YOUR FAMILY
41. Number of other adults in your household:
42. Adults
Age:
Gender:
Adult #1:
Adult #2:
Adult #3:
Adult #4:
43. Number of children in your household:
44. Children
Age:
Gender:
Child #1:
Child #2:
Child #3:
Child #4:
45. Describe your children's experience with dogs, if any.
46. If you do not have any children living with you, will your rescue dog come into regular contact with children under the age of 8?
yes
no
47. If yes, how often?
48. What ages?
49. Does anyone in your household have allergies?
yes
no
50. If yes, please explain:
51. Does anyone in your household have behavorial problems or disabilities?
yes
no
52. If yes, please explain:
53.Is everyone in your household aware of and in agreement with adopting a rescue dog?
yes
no
54. If not, who is not in favor and what are their concerns or objections?
ABOUT YOUR PETS, PAST AND PRESENT
55. Please list current pets living with you (excluding fish). If no pets, leave blank.
Pet's Name
Type i.e. dog/cat
Breed (dog only)
Age
Gender
Spayed/Neutered?
How long owned
1
2
3
4
5
6
56. Previous DOG(S) you owned within the past 10 years. If none, leave blank.
Pet's Name
Breed
Age
Gender
Spayed/Neutered?
How long owned
What happened to dog?
How long ago
1
2
3
4
5
6
57.Have you ever had to rehome a dog, or return a dog to a shelter or rescue, and if so, why?
58. If you have never been the primary caretaker of a dog, please describe your dog experiences:
59. Current veterinarian:
60. Phone Number
-
Area Code
Phone Number
61. Previous veterinarian:
62. Phone #:
-
Area Code
Phone Number
PLANS FOR YOUR RESCUE DOG
63. Who will be the primary caretaker for the dog?
64. When no one is home, the dog will be:
Crated
Have free run of the house
Restricted to certain room
Kept outdoors
65. How will you exercise your dog?
66. How long will your dog be left alone on a regular basis?
TWO PERSONAL REFERENCES REQUIRED
67. First reference: Full Name
First Name
Last Name
Relationship to applicant:
Phone Number
-
Area Code
Phone Number
68. Second reference: Full Name
First Name
Last Name
Relationship to applicant:
Phone Number
-
Area Code
Phone Number
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