Pet Adoption ApplicationName(Required) First Last Address(Required) Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Your Phone #(Required)Your Email Address Your AgePlace of Employment(Required)Work Phone #Please provide a personal referenceReference Name(Required) First Last Reference's Address(Required) Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Reference's Phone #(Required)Please provide the following information about your householdHow many people live in your home?(Required)How many adults?(Required)How many children?(Required)Ages(Required)Is anyone in your family allergic to animals?(Required) Yes NoIf allergic, indicate which animals(Required) Allergic to cats Allergic to dogs OtherIs everyone in your household aware of your intention to adopt a pet?(Required)Who will be the primary caregiver of the pet?(Required)Who will be financially responsible to provide adequate food, shelter, vaccinations, additional vet care as needed for the pet you plan to adopt?(Required)Where do you live?(Required) I rent I own I live with my parentsIf renting, have you notified your landlord and been approved?(Required)Pet Adoption InfoName and/or description of pet you are applying for(Required)Why do you want to adopt a new pet? (check all that apply) Companion for self Companion for children Companion for another pet Walking/Jogging/Hiking partner Protection Gift Replacement Pet OtherOther reason (please describe)(Required)How many days a week will the pet be left alone at home & how many hours per day will the pet be left alone at home? Please describe:(Required)Where will your pet be kept during the day? (check all that apply):(Required) Indoors Outdoors Dog Pen Crate Basement Garage Other (please describe)Other (please describe)(Required)Where will your pet be kept during the night? (check all that apply):(Required) Indoors Outdoors Dog Pen Crate Basement Garage Other (please describe)Other (please describe)(Required)Where will the pet be expected to relieve itself?(Required)If adopting a dog, do you have a fenced yard?(Required) Yes NoIf fenced, please describe the height and type of fence:(Required)If adopting a dog, how do you plan to house train your dog?(Required)Have you owned pets in the past? Please describe(Required)Have you ever given up or rehomed a pet? Please describe(Required)During the last two years have you lost a pet (not to death)? Please explain(Required)If any pet died in the last 3 years, describe circumstances:(Required)Dogs and cats can live 15 or more years. Are you prepared to keep them for their lifetime?(Required) Yes NoWho will take your pet(s) should you be unable to care for them?(Required)It may take your new pet a month to adjust to a new home, especially if other pets are involved. Are you prepared to allow this much time? Yes NoWhen would you be ready to bring your new pet home if approved?What type(s) of pet(s) do you own currently?(Required)NameType/breedKept where?AgeNeutered?SexStill own? Add RemoveWho is (was) your veterinarian for your pet(s)?Veterinarian Name(Required) First Last Veterinarian Address(Required) Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Veterinarian Phone(Required)Signature(Required) I agree to Animal Rescue Foundation's termsBy signing below, I certify that the information I have given is true and that I recognize that any misrepresentation of the facts may result in my losing the privilege of adopting a pet from ANIMAL RESCUE FOUNDATION (ARF). I authorize investigation of all statements on this application.
