Furry Tail Endings Adoption Application Thank you for your interest in adopting a dog rescued by FurryTail Endings Canine Rescue (FTECR). FTECR wants to make certain that every animal adopted goes to a loving home where it will be well cared for. Because of this, our application asks a number of detailed questions which are necessary for our screening process. FurryTail Endings Canine Rescue is an all volunteer rescue that does not have a shelter. All animals are placed into loving foster homes until they find their forever homes which could be located anywhere in NJ. * Adoptees must live within a 75 mile radius of Stewartsville, NJ. * We do not adopt pets to residents of major cities (example: Philadelphia, Manhattan, Brooklyn. Jersey City, Newark and Bayonne) * Adoption fees are $500 for Puppies up to 11 mos & $450 for Dogs 1 yr & older - $300 for seniors. * Due to previous adopters not following the adoption contract, a $100 deposit is required for spay/neuter. * Deposit is refundable ONLY if procedure is done by the date on the contract & we receive written proof within 7 days. * All information will be kept confidential. * Personal references may not be family members. * If you have any questions, please email us at furrytailendings.1103@gmail.com or use our contact form. * Please allow up to a week for processing your application. * Thank you! Step 1 of 8 12% Basic InformationName of Dog You're Interested In*Your Name* First Last Your Age*NOTE: You must be at least 21 to adopt from FTECR. Proof of age will be required prior to completing adoption.Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Note: FTECR cannot accept applications from distances over 75 miles from Stewartsville, NJ. Email* EmployerDaytime Phone*Cell PhoneSpouse/Partner Name First Last Spouse/Partner Phone About Your HomeType of Residence*HouseCondo/TownhouseApartmentMobile HomeDo You RENT your home OR do you own a home governed by a home owners association?*No I do not have landlord or home owners associationYes I do have a landlord or home owners association.If you are a renter or live in a townhouse or condo, does your landlord/association allow dogs?*YesNoN/AName of Landlord or Homeowners Association*Landlord or Home Owners Association Phone Number*How many years have you lived at this address?*Please enter a value between 0 and 99.If less than one year enter "0"Any any plans to move in the next few years*YesNoHow many times have you moved in the past five years*What would you do if you moved to a residence where dogs are not permitted About Your FamilyHow many adults live in this household?*How many children live in this household?*Ages of children in the household?*Number of children who visit?*Ages of children who visit?*Are all members of your household in agreement about adopting a dog?*YesNoIs anyone in your houshold nervous or unsure around dogs*YesNoFor whom would you be adopting this dog?*Myself / My FamilyMy child / childrenSomeone elseWho will be the primary caregiver for this animal?Who will be financially responsible for this animal?*Do any members of your household have asthma, or have allergies to dogs?*YesNoIf yes, who?Describe your household activity/noise level*HighMediumLowHow often do you travel?*FrequentlyOccasionallyRarelyNeverHow will you care for your dog when you are away from home?*In the event of an emergency, who would care for your dog or what arrangements would you make?*For how many hours would the dog be alone during the day?* About Your Current PetsPlease List Your Current PetsNameSpecies/BreedAgeGender (m/f)Spayed/Neutered (y/n)Owned How LongUp to date on vac (y/n) Click the plus sign to add another line.If you have a cat, does it get along with dogs?YesNoN/AIf you have a cat is it declawed?YesNoN/AIf you have a dog does it get along with other dogs?YesNoN/AWhat is the name and phone number of your veterinarian?Providing vet's phone number speeds the verification process.May we call vet to verify vaccinations and spay/neuter status?YesNoN/AAre you experiencing any difficulties with your current pets in terms of health or behavior?YesNoN/APlease describe: Pet HistoryHave all of your family members been around dogs?*AllMostSomeNoneHave you had the experience of being primary caregiver to a dog?*YesNoHave you ever given a pet away, given it to a shelter or rescue group, returned it to a breeder or sold it?*YesNoPlease explain:Have you ever had a pet for a short period of time and it didn't work out?*YesNoPlease explain:Have you ever had an animal lost or stolen?*YesNoPlease explain:Have you ever had to retrieve your animal from a pound, shelter or animal control facility?*YesNoPlease explain:Have you ever had an animal die as the result of being hit by a car, being poisoned or from unknown causes?*YesNoPlease explain:Are your current dogs licensed?*YesNoN/AAre your pets vacinations current?*YesNoN/AHave dogs received heartworm preventative?*YesNoN/AHave cats been tested for feline leukemia?*YesNoN/AHave you ever adopted from FTECR?*YesNoPlease list pets owned over past 10 years (but not current pets)NameSpecies/BreedSpayed/Neutered (y/n)Owned How Long?What happened to this pet?How long ago?Vet you used? Click the plus sign to add another line. Plans for Your New PetWhere will the dog live?*Indoors mostly/Outdoors for elimination and exerciseOutdoors mostly/Indoors on occasionOutdoors onlyNot sureWhere will the dog be when nobody is home?*IndoorsOutdoorsIndoors or outdoorsDo you have a fenced in yard?*YesNoIf you have a fenced in yard please describe it:Electric, Chain link, or Privacy? How high?What veterinary practice do you plan to use?*If you adopt an animal who has not been spayed or neutered do you:*Intend to have it spayed/neuteredIntend to let it have puppiesNot sureAre you aware that some dogs require a period of weeks or even months to adjust to their new home/enviroment/family/other pets?*YesNoAre you willing to allow for this adjustment period?*YesNo, I prefer a pet who will adjust quicklyNot sureAre you willing to bring your pet to a veterinarian for yearly exams, and for vaccinations per your veterinarian's recommendations?*YesNoNot sureAre you able/willing to pay for emergency care, which could result in a bill of $200 to $1,000 or more?*YesNoNot sureAre you able/willing to pay for pet expenses including veterinary care, supplies, toys, boarding/pet sitting, grooming, food, etc.?*YesNoNot sureAre you able to commit to providing a home for a dog for the life of the dog?*YesNoNot sureWhat circumstances might justify giving up a dog? (check all that apply)* Baby Moving Divorce Dog not getting along with other pets Allergies New household member dislikes dog Shedding Behavior probems Housesoliling/urine marking Want to travel Dog becomes seriously ill Destructive Children lost interest Too time consuming None Other Please indicate "other" reason for giving up dog:*If your dog exhibits behavioral or adjustment issues, would you be willing to seek the advice of a FTECR representative?*YesNoNot sureWould you be willing to pay for obedience or behavioral sessions?*YesNoNot sureDo you feel what you feed your dog is important?*YesNoNot SureWhat food do you feed your dog?How do you feel about your dog being on the furniture/bed?*My couch/bed is their couch/bedI let the dog decideIt's absolutely forbidden PreferencesWhat size dog do you prefer (Check all that apply)?* Small Medium Large Any Size Reason for adoption*CompanionshipWatch dogEnergy Level*LowMediumHighI intend to (check all that apply)* Walk dog on a leash Walk dog off leash Bring to dog park Hunt with dog Jogging or hiking with dog Let dog exercise in yard I prefer a dog who is (check all that apply)* Adult Senior Puppy Male Female Spayed/neutered Indoor only Indoor/outdoor Outdoor only Mellow, quiet Lap dog Protective Very active/energetic Mainly outdoor dog Happy to meet new people Hypoallergenic Likely to be housetrained Breeds I prefer:*When it comes to relating to dogs, I consider myself:*Strict, demanding, a strong leader (dog must sit for a cookie and follow my rules)Lenient, a little wishy washy, easily coerced by the dog (the dog looks cute so he gets a treat without sitting, can jump on the couch uninvited)Somewhere in betweenMy ideal dog would:*Bad doggie habits I cannot tolerate:*Please share with us anything you would like for us to know about the new dog that you would like to add to your family:Would you be interested in learning about some of our 'special needs' or 'long-term resident' dogs?YesNoMaybe in the futureWould you be willing to have an in-home visit?*YesNoNot sure Personal References (Not Family Members)NOTE: References must **NOT** be family members.Personal Reference #1*NameRelationshipPhone Number Personal Reference #2*NameRelationshipPhone Number Personal Reference #3*NameRelationshipPhone Number Form SubmissionBy clicking the Submit button below, I certify that: * The information I have given is accurate *I understand that FTECR has the right to deny any application * I give permission for a representative of FTECR to call the references and veterinary practices I have listed Copyright (C) 2018 Furrytail Endings Canine Rescue Form Design by The Round Mountain Group, LLC