Name of the dog(s) you are interested in adopting:
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Why are you interested in adopting a dog:
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Companion
Hunting
Gift for a relative
Guard
Other
Select one:
If other, please explain:
What types of activities would you like to enjoy with your dog - check all that apply:
What energy level are you looking for in a dog:
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Higher than Average
Average
Lower than Average
Why are you interested in this specific dog(s)?
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What, if any, behaviors would cause you to return this dog to FMAR?
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Name:
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First Name
Last Name
Phone Number:
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(###)
###
####
Email Address:
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Driver’s License Number:
*
Address:
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Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Length of time at your current address:
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Less than 6 Months
6 - 12 Months
1 - 3 Years
3 + Years
Do you Rent or Own?
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Rent
Own
If renting, please provide the name, address, phone number, and email address of your landlord:
If renting, what is the pet policy where you live?
Home Type
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Condo
House
Apartment
Manufactured Home
My home has a:
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Fenced yard
Stationary tie-out
Invisible fence
Outdoor run
Dog House
Please provide a description of the above (type/fence height):
We may require a home inspection prior to approving an adoption. Do you agree to a home inspection?
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Yes
No
How many adults live in your home?
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How many children live in your home? Please provide ages for all children under the age of 16.
*
Is everyone in the household agreeable to this adoption?
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Yes
No
Please provide two references (other than household members) – Name, address, phone number, and email.
*
On average, how many hours a day would the dog be left alone on? Please include on week days and weekends.
Where will the dog stay during your time away from home? Check all that apply:
*
If other, please explain:
Where will the dog stay at night?
*
If other, please explain:
How would you describe the activity level in your home?
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Higher than average
Average
Lower than average
How would you describe your experience with dogs?
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Higher than average
Average
Lower than average
What types of dogs do you have experience with:
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Is anyone in your household allergic to dogs?
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Yes
No
Tell us about your current pets (Please include Species, Breed, Male or Female, How long you've had them, Spayed/Neutered):
*
Former pets from the past 5 years (Please include age and why they are no longer with you):
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Were any of the above pets adopted from a rescue or shelter?
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Yes
No
If yes, please provide the name of the shelter and date of the adoption:
Please provide the contact information (including address and phone number) of your current veterinarian:
*
All of our dogs and puppies are up to date on age appropriate vaccinations and are on monthly heartworm, flea, and tick prevention. Are you prepared to continue vaccinations and preventatives?
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Yes
No
Are you prepared to take on the costs of owning a dog for the rest of its life? These costs include providing nutritious food and routine medical care and potentially expenses such as medical care for an illness or injury, grooming, boarding, training, etc?
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Yes
No
Are you able to make a commitment to this dog for the rest of its life?
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Yes
No
Who will be primarily responsible for this dog?
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Who will take over responsibility for this dog in the event the above is unavailable (i.e. vacation/illness/emergencies)?
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How did you hear about this animal?
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Social Media (Facebook/Instagram)
FMAR's Website
Friend
Adopted Previously
Petfinder (or other pet site)
General Internet Search
PetCo Event, Other Event
I certify that the above is true and that any false information may result in nullifying the adoption:
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Yes
No
Full Name
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First Name
Last Name
Date
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MM
DD
YYYY
