APF's Dog Adoption Form

APF's Dog Adoption Form

Animal Protection Foundation
Great news; you want to adopt a dog or puppy from us. By adopting a homeless pet, you save a life and receive a lifetime of love in return.

We need to get a few details from you so we can find the right match for you and also to secure the future of both, you; as a potential parent, as well as our pet.
Contact Information
NAME *

First Name Last Name
HOW OLD ARE YOU? *
years
PLEASE PUT A LINK TO YOUR FACEBOOK AND/OR INSTAGRAM PROFILE/S *

ADDRESS *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

HOW LONG HAVE YOU BEEN STAYING AT THIS ADDRESS? *
MOBILE PHONE NUMBER *

Code Phone Number
Email
example@example.com
WHAT IS YOUR OCCUPATION *
WHAT IS THE NAME OF YOUR EMPLOYER *
HOW DID YOU HEAR ABOUT US
History
HAVE YOU EVER OWNED PETS ? *

YES NO
WHAT KIND OF PET?
IF YES, WHAT HAPPENED TO THEM?
DID YOU EVER GIVE UP A PET? *

YES NO
IF YES PLEASE EXPLAIN?
FAMILY, EXPERIENCE AND HOUSING
DO YOU CURRENTLY OWN A PET *

YES NO
IF YES, WHAT PETS DO YOU OWN NOW?
IF YES, ARE YOUR CURRENT PET/S GOOD WITH DOGS?

YES NO
ARE THEY SPAYED OR NEUTERED?

YES NO
IF NOT, PLEASE EXPLAIN:
WHEN HAVE THEY BEEN LAST VACCINATED?

Month Day Year
Date Date Picker Icon
DO YOU HAVE ANY VISITING ANIMALS? (friends and family) PLEASE GIVE DETAILS
WHAT IS THE NAME & PHONE # OF YOUR VETERINARIAN?
ARE THERE CHILDREN IN THE HOUSEHOLD? *

YES NO
IF YES, WHAT ARE THEIR AGES?
HOW MANY ADULTS ARE IN YOUR HOUSEHOLD? *
DO YOU OWN YOUR HOME? *

YES NO
IF RENT? (Do you have landlord approval?)

YES NO
DO YOU HAVE A GARDEN? *

YES NO
IS YOUR YARD SECURELY FENCED?

YES NO
DOES ANYONE IN THE FAMILY HAS AN ALLERGY TO PETS? *

YES NO
DOES EVERYONE IN THE FAMILY AGREE TO ADOPT A PET? *

YES NO
HOW WILL YOUR DOG BE EXERCISED? *
HOW OFTEN? *
WHERE WILL HE SPEND THE DAY? *
WHERE WILL HE SPEND THE NIGHT? *
IF OUTSIDE, DO YOU HAVE SHELTER AVAILABLE FOR HIM?

YES NO
IF YES EXPLAIN
WHEN DO YOU EXPECT TO LEAVE YOUR DOG ALONE AT HOME? *

Mornings Afternoon Evening
FOR HOW LONG?
HOW OFTEN?
ARE YOU PLANING FOR ANY OF THE FOLLOWING?

Moving House Planning a vacation in the next few weeks Travel None of the above
ARE YOU FINANCIALLY PREPARED TO PROVIDE THE NECESSARY CARE FOR YOUR PET: INCLUDING PROPER FOOD, VACCINATIONS, PARASITE CONTROL (FLEAS, TICKS, WORMS, ETC.) ADEQUATE SHELTER, AND VETERINARY CARE FOR YEARLY CHECK-UPS AND MEDICAL EMERGENCIES? *

YES NO
Your Pet
Have you seen a dog or puppy on our website or Facebook page that you are interested in? If so please tell us the name
WHAT SIZE OF DOG DO YOU WANT TO ADOPT?

Small Medium Large Any
GENDER?

Male Female Any
AGE?

Puppy Adult Senior Any
CONDITION?

Healthy Special Needs
DO YOU WANT TO ADD ANYTHING?
BY TYPING MY FULL NAME BELOW, I AFFIRM THAT ALL INFORMATION ABOVE IS TRUE. I REALIZE THAT THIS IS A LIFETIME COMMITMENT AND WILL ENDEAVOR TO GIVE THIS PET A HAPPY AND HEALTHY HOME. IF THERE ARE PROBLEMS WITH THIS PET OR I MUST GIVE HIM UP I WILL CONTACT THE MCCOOK HUMANE SOCIETY. *
TYPE FULL NAME HERE
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APF's Dog Adoption Form

Contact Information

History

FAMILY, EXPERIENCE AND HOUSING

Your Pet