Apply for Adoption Today! Open Form Adoption Contract Name * First Name Last Name Address * City * State * Pennsylvania Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho IllinoisIndiana 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 Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming ZIP * Rent/Own * Rent Own Other Landlord/Phone# Housing Type * House Apartment Live With Parents Number of adults in home * Number of children in home * Ages of Children Significant Other's Name How long resided at current location? * Would we be allowed to do a home visit before and after? * Yes No Home/Cell Phone * Email Age * Employment Type * Full-Time Part-Time Unemployed Student Retired Employer Phone Number Source of Income if not employed If relocate to another residents or State, would your pet come with you and your family? * Yes No Who will be primarily responsible for this pet? * How many hours will your pet be alone per day? * Will your cat/dog be inside or outside? * Inside Outside If you go away on vacation or have an emergency, who will care for your pet? * How many years do you expect to care for this pet? * Sometimes it takes animals awhile to adjust to new homes. How long would you give your pet to adjust? * How much do you think it will cost to care for your pet per year? * $ Do you plan on declawing your cat? * Yes No N/A Vet Reference/Phone # Please call your vet and inform them that we will be calling. Name of family member, pet is registered under? Last time pets were at the vet? MM DD YYYY Are your pets spayed/neutered? Yes No Current on vaccinations? Yes No Personal References * Please list 3 references (Name and Phone Numbers) that are not related to you or live in the same residence as you. Why do you want this pet? * Companion Companion for other pet Gift Gift for Child Please list the pets you currently have and have had in the past 10 years. Include Type, Name, Age when passed, Sex, Spayed/Neutered, Time Owned Name of Dog/Cat want to adopt * If you are not applying for a specific animal, list type (such as Kitten, Cat, Puppy, Dog) Color Age Sex Check here to swear that everything above is true * D&H Furrever Homes seeks out loving and Furrever homes to our animals. We reserve the right to request additional information or reject the application, if not in the best interest of our animals. Confirm
