First Name*
Last Name*
Address*
City*
State/Province*
Zip/Postal Code* -
Email*
Home Phone*
Cell Phone
Date of Birth*
Which animal are you interested in Choose an animal: Cecilia Cricket Cyrus Fallon Freckles Gideon Jackie Kimmy Mischa Moana Mr.Morningstar Nemo Penny Jo Punkin Sasha Squiggy Therese Tipper Waffle
In what type of home do you live* Choose one: Single Family Duplex Apartment Townhouse Condominium Mobile Home Military Housing
Do you own or rent your home* Choose one: Rent Own
If you rent, have you received the approval of your landlord to have an animal Choose one: Yes No
If you rent, please enter your landlord's name and phone number. If you don't rent, please enter N/A.*
Do you live in association? * Choose one: Yes No
If yes, what are the rules/restrictions?
How many people reside in your household*
How many adults (18+) are in the home?* Choose one: 1 2 3 4 or more
Please list first name, last name, & date of birth for any additional adults living in the house hold*
How many children (under 18) are in the home?* Choose one: None 1 2 3 4 or more
If there are children, lease list the ages
Is your yard fenced* Choose one: No Yard Unfenced Yard Yard Partially Fenced Yard Completely Fenced
If you don't have a fenced yard, please describe how you will exercise and confine the animal when outside.
Will the animal be kept inside or outside* Choose one: Inside Only Outside Only Inside and Outside
For cats only: Are you planning to declaw* Choose one: Yes No N/A
Where will the animal be kept when you are not home*
How much time will the animal spend alone during the day*
Please list your current pets (Include breed, gender, age)*
Are your current pets up to date on vaccines? If no, please explain*
Are your current pets spayed/neutered? If no, please explain*
Please list the Veterinarian's clinic name that can verify your current pets are UTD and spayed/neutered. (If you do not have pets, please enter N/A.)*
Please provide the veterinarian's phone number that can verify your pets are UTD and spayed/neutered. (If you do not have current pets, answer N/A.)*
Are you willing to have a Fur-Ever Home representative visit your home by appointment?* Choose one: Yes No
What is the best way to contact you? *Please note we run primarily via email** Choose one: Call Text Email Facebook
Animals are as individual as people. Are you willing to spend the time and effort to help this pet adjust to your home and lifestyle?* Choose one: Yes No
List two references (At least one can not be a family member). Include email address or phone number.*
How did you hear about us?
I certify that the information entered on this application is true. Enter your name and date*