Adoption Application | Furever Friends Dog Rescue of WNY, Inc.

Today's Date: *

Name *

First

Last

Street Address *

Apt #

City *

Adopters must live within 75 miles of Amherst, NY. No Canadian adoptions.

State *

Zip Code *

Home Phone *

Cell Phone *

Email *

Date of Birth (Adopters must be 21 years of age or older): *

Occupation *

Current Employer *

Have you ever adopted a dog? If so, how did it go? *

Please tell us briefly why it is your desire to adopt a dog *

Please list any previous experience working with animals/dogs in particular: *

List your top 10 dog breeds you would be most interested in adopting: *

(You don't have to list 10.)

Please select gender preference(s): *

Male
Female

Please select weight preference(s): *

Please select age preference(s): *

Puppy (2-11 months)
Young Adult (12-24 months)
Adult (2-7 years)
Senior (8+ years)

Reference #1: Name *

First

Last

Your reference cannot be related to you

Reference #1: Phone Number *

Reference #1: Relationship *

Reference #1: Number of years known *

Reference #2: Name *

First

Last

Your reference cannot be related to you

Reference #2: Phone Number *

Reference #2: Relationship *

Reference #2: Number of years known *

Name of Veterinarian *

Phone Number of Veterinarian *

May we contact your Veterinarian? *

Yes
No

If yes, please inform them that a representative of Furever Friends will be contacting them.

All potential adopters may require a home visit from a representative of Furever Friends. Do you own your home? *

Yes
No

If you answered no to the above, please explain:

If you are a renter, have you verified that dogs are allowed in your home? *

Yes
No
I am not a renter

If you are a renter, please provide your landlord's name and phone number.

Do you plan on remaining at your current address for at least 6 months? *

How many hours during an average day will the dog be without human supervision? *

Where will the dog(s) be kept while you are not at home?

Do you have a fenced-in yard? *

Yes
No

Please understand that all rescue dogs pose a serious flight risk, so they must always be confined and supervised, and CANNOT be left unattended in a yard, even if the yard is enclosed.

Please list name, relationship, and age of everyone that resides in your home. *

Do all members of your family agree on the commitment and responsibilities of owning a dog? *

Yes
No

If you answered no to the above, please explain:

Are there other pets currently living in your home? *

Yes, and they are all spayed/neutered.
Yes, however one or more of them are not spayed/neutered.
No

All Furever Friends dogs have received all necessary age appropriate vaccinations and have been treated with a flea preventative (except in winter).

If you answered yes to the above, please list the breed and age of each pet.

Have you ever given up a pet? *

Yes
No

If you answered yes to the above, please explain:

Who will care for the dog while you are away? Please include name, relationship and age. *

Do young children visit your home? *

Yes
No

If you answered yes to the above, please list age(s):

Most of our rescue dogs are not housetrained. Do you have a plan for handling this? *

Yes
No

By submitting this application, I acknowledge that I have reviewed and answered each question truthfully. I also understand that should I agree to adopt a dog from Furever Friends Dog Rescue of WNY, Inc., I will be required to sign a contract. *

I agree