Previous address or mailing address
Employer Information
References Please provide two non-related personal references who can speak to your ability to care for a new pet
Home Environment How many members live in your household?
List names and birthdates of those in the household
If yes, please explain ANY form of crimes of battery, Domestic Violence, warning/home checks/citation for any abuse etc...regardless of the outcome
Vetinarian Information
Adoption Intentions I would like to adpot a pet for (Please check all that apply)
For the benefit of my child
What factors caused you to apply for this animal?
Animal Care Please describe any physical or mental activites in which you plan to engage your pet
If no, how are you planning to take your animal outside? [ Dog related ] Please describe your yard or area.
How do you plan on training the animal?
How would you discipline your animal if it went to the bathroom on your floor or discpline it for any other reason?
Please describe any situation that would cause you to feel the need to surrender your pet.
Please tell us any past experience you have had with this breed or other similar experiences.
Current Animals
Other Please list any additional information that you feel may be relevant to help us process your application.
Acknowledgements I am at least 18 years old.
I have consent to adopt an animal from all adults living in my home.
I have verifiable indentification showing my present address.
If renting, I have a written letter of approval from my landlord to have an animal in my rented home. I will also allow FCHS to speak with my landlord about any restrictions on weight, breed, etc.
I agree to not let the animal run at large or become a public nuisance.
I understand that, even though FCHS does their best at determining the breed of an animal, we cannot guarantee the accuracy of this determination.
I understand that FCHS has the right to accept or deny my application for adoption.
I realize that, although FCHS will give this application full consideration, all animals will go to the home that is determined to be the best match for their individual needs.
I authorize the investigation of all information provided in this application, using any background check sites etc. I authorize my veterinarian to release any information requested from the FCHS.
Adoption Application Disclaimer FCHS will not delay the processing of my adoption application, as it is our goal to place our animals in a timely manner. Please understand that we receive applications via the internet, US mail and in person. You may not be the first and/or only applicant on any given pet. Multiple applications for one pet can result in an extended processing time while we work to find the best fit, based on the pet’s individual needs and history.
FCHS reserves the right to refuse to adopt our animals to anyone for any reason. We strive to find safe, permanent placement for our pets. If, in the course of our processing of your application, or through observations during any visitations, we are not confident that the match would be successful, we may deny adoption at any point of the adoption process.
FCHS will not adopt out any pet if deem to be unadoptable due to severe illness or behavioral instability. You are adopting your pet from the FCHS as is and assume responsibility for its health and wellbeing. While any pet adopted may be returned to us for ANY REASON at ANY time, refunds will only be given within three days of adoption minus the surrender or any pre- arranged fee.
Any other pets that live in the household must be properly introduced to canines that are to be adopted.
FCHS does not adopt pets as gifts for any reason.
This application becomes property of the FCHS.
I have read and acknowledge the above disclaimer.
I certify that the information I have given is true. I realize that any misrepresentation of facts may result in my application being denied and I will lose the privilege to adopt a pet.
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