Adoption Application | FurryTail Endings

Basic Information
Name 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 State ZIP Code

Note: FTECR cannot accept applications from distances over 75 miles from Stewartsville, NJ.
Email*
Employer
Daytime Phone*
Cell Phone
Spouse/Partner Name
First Last
Spouse/Partner Phone

About Your Home
Type of Residence*
- House
- Condo/Townhouse
- Apartment
- Mobile Home
Do 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 association
- Yes 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?*
Name 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*
How 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 Family
How 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?*
Is anyone in your houshold nervous or unsure around dogs*
For whom would you be adopting this dog?*
Who 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?*
If yes, who?
Describe your household activity/noise level*
How often do you travel?*
How 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 Pets
Please List Your Current Pets
Name Species/Breed Age Gender (m/f) Spayed/Neutered (y/n) Owned How Long Up to date on vac (y/n)

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If you have a cat, does it get along with dogs?
If you have a cat is it declawed?
If you have a dog does it get along with other dogs?
What 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?
Are you experiencing any difficulties with your current pets in terms of health or behavior?
Please describe:

Pet History
Have all of your family members been around dogs?*
Have you had the experience of being primary caregiver to a dog?*
Have you ever given a pet away, given it to a shelter or rescue group, returned it to a breeder or sold it?*
Please explain:
Have you ever had a pet for a short period of time and it didn't work out?*
Please explain:
Have you ever had an animal lost or stolen?*
Please explain:
Have you ever had to retrieve your animal from a pound, shelter or animal control facility?*
Please explain:
Have you ever had an animal die as the result of being hit by a car, being poisoned or from unknown causes?*
Please explain:
Are your current dogs licensed?*
Are your pets vacinations current?*
Have dogs received heartworm preventative?*
Have cats been tested for feline leukemia?*
Have you ever adopted from FTECR?*
Please list pets owned over past 10 years (but not current pets)
Name Species/Breed Spayed/Neutered (y/n) Owned How Long? What happened to this pet? How long ago? Vet you used?

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Personal References (Not Family Members)
NOTE: References must **NOT** be family members.
Personal Reference #1*
Name Relationship Phone Number
Personal Reference #2*
Name Relationship Phone Number
Personal Reference #3*
Name Relationship Phone Number
Form Submission
By 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

Basic Information