FFR Adoption Application

Items marked with an * are required fields

Please fill our this Application and hit Submit once - it will be emailed to us.
We will get back to you as soon as possible.
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Thank You for your interest.

First Name*:	Last Name*:
Street Address*:
City*:	State: Texas Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Utah Vermont Virginia Washington Washington, DC West Virginia Wisconsin Wyoming
Home Phone*:	Work Phone:
Cell Phone:	Pager:
Zip Code*:	Email Address*:
Do you own or rent your home? Own Rent	If you rent, are pets permitted in your lease? Yes No
Please indicate weight limit, if applicable:	Is your yard fenced? Yes No If not, are you willing to install a fence? Yes No
Landlord's Name:	Landlord's Phone:
Landlord's Address:
Type of Home: Single Fam. Duplex Condo Townhouse Apartment Farm	If there are children in the household, what are their ages? No children Under 2 yrs. 2-5 yrs. 6-10 yrs. 11-15 yrs. Over 15 yrs.
Are you planning to move in the next six months? Yes No	Would your pet go with you if you moved? Yes No
List animals you currently own or that are in your care/house and those you have owned in the past five years, if you need more room list in comment box below: Dog Cat Name Male Female Spay/Neuter Yes No Housed Inside Outside Both How Long Owned? Where is it now? Dog Cat Name Male Female Spay/Neuter Yes No Housed Inside Outside Both How Long Owned? Where is it now? Dog Cat Name Male Female Spay/Neuter Yes No Housed Inside Outside Both How Long Owned? Where is it now? Dog Cat Name Male Female Spay/Neuter Yes No Housed Inside Outside Both How Long Owned? Where is it now?
Reason for adopting:
Which pet are you interested in adopting?
Who will be responsible for this animal?
Is anyone in the household allergic? Yes No	Are all members of your household aware that you are interested in adopting a pet? Yes No
Where will this pet be kept while you are away from home?
Who will be responsible for this pet while you are on vacation?
What are your plans for disciplining/training your pet?
Have you ever given away/sold or released an animal to a shelter or rescue group? Yes No
If yes, why?
Will you provide annual vaccinations and any necessary medical care? Yes No
Who will be responsible for this pet if you have to move?
Where will this pet be kept during the day?
Where will it be kept at night?
Vet's Name:	Vet's Phone:
Vet's Address:
Comment box for additional information: