ADOPTION APPLICATION

Thank you for your interest in adopting an animal from Four Legged Freedom Rescue.We are a nonprofit all volunteer organization. We rely solely on donations to fund our organization and foster homes to house our animals. After your application has been reviewed and approved we will be happy to schedule a meet and greet. To be considered for adoption you must be 18 years of age and provide proper identification.

Animals available for adoption have been placed in our care from a wide range of sources, some unknown. All animals available for adoption have been seen by a veterinarian, dewormed, spayed or neutered, treated for any known medical conditions, and have received all age appropriate tests and vaccines listed below. The animal’s health is routinely monitored while in our care but there is always a chance that an animal is incubating an illness or disease without showing any clinical signs.

All dogs have been immunized against the following diseases:

* Canine Distemper Hepatitis

* Leptospirosis Canine Parvo VirusInfectious

Tracheobronchitis

* Rabies (dogs three months or older)

* Tested for Heartworm

All cats have been immunized against the following diseases:

* Feline Viral Rhinotracheitis

* Feline Calici Virus

* Feline Panleukopenia

* Rabies ( cats three months or older)

* Tested for FeLV/FIV

ADOPTION FEES

Cats and Kittens = $300

Dogs and Puppies =$600

Name*

First NameLast Name

Spouses name (if applicable)*

First NameLast Name

Age *

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number*

Area CodePhone Number

Email*

example@example.com

Employer Name and Occupation *

Which animal are you interested in adopting:*

Have you adopted before? If so, from where and when?*

Occupancy*

I own my homeI rentI live with a parent/guardianI live with a friend/roommate

If you rent, do you have your land lords permission to have a pet?*

YesNo

Does your landlord have any restrictions? ( do they allow both cats and dogs, any breed restrictions or size limits?)*

Landlord’s name and contact info: *

If you live with a parent/guardian please list their name and contact info:*

If you live with a friend/roommate please list their name and contact info:*

Please list the ages of the people who live in your household: *

Which best describes your household:*

Quiet - very few visitorsModerate - visitors on occasionActive - we are in and out alotOther

Please describe your household dynamics: *

Do you have current pets?*

YesNo

If yes, please list their name, age, breed, gender, as well as any medical issues: *

Are your pets up to date on their vaccinations?*

YesNo

If no, please explain why they aren’t:*

Are your pets spayed/neutered:*

YesNo

If no, please explain why they are not: *

If you have cats are they kept indoors or outdoors?*

Indoor onlyOutdoor onlyInn and Out

Have you ever surrendered or re homed a pet? If yes, to who and why?*

Have you had pets in the past? If yes, how long ago? Please list their name, gender, breed, veterinarian, and what happened.*

What are you looking for in your future pet? *

How will you correct unwanted behavior: *

Do you have a plan for your animals if you were suddenly unable to care for them? ( example: illness, loss of job, etc)*

YesNo

Please describe your plan: *

If adopting a cat, will they be allowed outdoors?*

YesNoN/A

If yes, under what circumstances? *

If adopting a cat, do you plan to declaw them?*

YesNoN/A

If adopting a dog, do you plan to crop the ears or dock the tail?*

YesNoN/A

How many hours per day will the animal be left alone: *

Where will the animal be kept when you are not home? (example: crate, free range, room, etc) *

** A new dog should never be left with free reign of the home when you are not home or cannot supervise them. Crate training is an excellent tool to keep your new dog safe while you are not home or unable to supervise them. Once you are confident that they can be trusted alone you can try leaving them unattended starting with small increments but be sure that toxic or dangerous items are out of reach. If used correctly and not abused (used as a punishment or too many hours per day) your dog will enjoy their crate and you may find they prefer to be in their crate when unattended. A dog’s crate creates a safe and secure place for them to retreat to. **

Where will the animal be kept when you are traveling: *

REFERENCES

Please list 3 personal references, only 1 can be related.

Name & Phone Number

How did you hear about our adoption services:*

Please provide any additional information you would like to share with us: *

VETERINARIAN INFORMATION

Please list your current / previous / planned veterinarian(s) and their phone number. Four Legged Freedom Rescue will contact them to verify your current pets are up to date on vaccines, spayed/neutered and that they are well cared for; this is a requirement for new pet adoptions.

***PLEASE CALL YOUR VET OFFICE(S) TO AUTHORIZE RELEASE OF INFORMATION TO FOUR LEGGED FREEDOM RESCUE.***

Veterinarian Name: *

Vet Hospital Name: *

Vet Hospital Phone Number: *

If your pets are listed under another name ( example; maiden name, boyfriend, or spouse ) please note that information below: *

TERMS AND CONDITIONS

I certify that I am at least 18 years of age and the information I have provided on this application is true. I also recognize that any misrepresentation or omissions may result in the loss of privilege to adopt from Four Legged Freedom Rescue.*

AgreeDisagree

I understand that Four Legged Freedom Rescue has the right to deny any application for any reason.*

AgreeDisagree

If interested in a particular animal, I understand Four Legged Freedom Rescue cannot hold any animal until I am approved.*

AgreeDisagree

I understand that the animals health is routinely monitored while in Four Legged Freedom Rescue’s care but there is always a chance that an animal is incubating an illness or disease without showing any clinical signs and therefore the animal’s health is not guaranteed*

AgreeDisagree

I understand that anything could happen in life, and if I find that I am no longer able to care for my adopted animal, I agree to contact Four Legged Freedom Rescue to reclaim the animal.*

AgreeDisagree

I understand that I am to immediately contact Four Legged Freedom Rescue in the event that my adopted animal is lost/missing.*

AgreeDisagree

I attest that the animal I am adopting is to be apart of my family in my home and not a gift or for anyone else.*

AgreeDisagree

I understand that both the deposit and adoption fee are non refundable.*

AgreeDisagree

Name*

First NameLast Name

Signature*