Adoption Application Instructions APPLY VIA Email: 1. From the website, download this form to your computer and fill out the application. 2. Create a new email, address it to AFTAInc@hotmail.com, and attach the completed application. PLEASE NOTE: 1. The responses you provide will help us find the best possible match between you and the dogs available for adoption. 2. AFTA reserves the right to conduct a home inspection prior to and post adoption arrangements. 3. If any information on this form is omitted, it will be discarded. 4. If it is discovered information was knowingly falsified, the adopter will return the dog sans fees to AFTA. 5. AFTA reserves the right to refuse any application. Adoption Application Please “x” the appropriate box if question does not require a written response. Adoption Information: 1. Was there a particular dog on our web site that you were interested in? ( Y ( N (If “yes,” please provide name below.) 2. If that dog has been adopted, or if you did not see a dog on the website, is there a particular breed/mix you would be interested in? ( Y ( N (If “yes,” please describe below.) 3. Sex: ( Male ( Female ( No preference 4. Preferred Age? 5. Oldest dog you would be willing to accept? 6. Would you be responsible for a dog with some health problems? ( Y ( N ( Perhaps 7. Would you take a dog with some behavioral problems? ( Y ( N ( Perhaps 8. Are looks or size important to you? ( Y ( N (If “yes,” please describe below.) 9. Are you prepared to you abide by, as applicable, AFTA policies, city, county, and state laws concerning pets? ( Y ( N ---------------------------------------------------------------------------------------------------------- Personal Information: 1. Complete name: 2. Complete residential address: 3. Complete mailing address (if different from residential address): 4. Home phone: 5. E-mail: 6. Best time to call: 7. Work status: ( Full-Time ( Part-Time ( Work at home ( Don’t Work ( Retired 8. Employer’s name and address: 9. Employer’s phone number: 10. Personal reference of an unrelated individual who has known you at least 1 year: Name: Phone number: Email: ----------------------------------------------------------------------------------------------------------- Your Family: 1. Marital status: ( Married ( Single ( Partner ( Widowed 2. Number of adults residing in your home? Relationship (if not noted above): 3. Is your spouse/partner in agreement with this adoption (signature required)? ( Y ( N 4. Is (are) your roommate(s), if applicable, in agreement with sharing their home with this animal (signature/s required)?: ( Y ( N 5. Number of children (and ages) living in your home: Number: Ages: 6. Will the addition of children give cause to displace this animal? ( Y ( N ------------------------------------------------------------------------------------------------------------ Your Home: 1. What type of home do you have? ( Single Family House ( Duplex ( Condominium ( Apartment ( Mobile Home ( Garage Apartment 2. Do you own or rent? ( Own ( Rent 3. Renters a. What provisions are in the lease regarding pets? Please send a copy via USPS to: AFTA, c/o 20 Homestead Rd Sagamore Beach, MA 02562, (Your application will be held 1 week in anticipation of delivery.). b. Landlord Name: Phone number: c. Should you relocate, are you prepared to find a residence that will allow you to keep your pet? ( Y ( N 4. Length of time at current address: ( 1 year or less ( 1 to 2 years ( 3 to 5 years ( 5 years or more If less than 1 year, provide complete previous address: 5. Is your property fenced? ( Y ( N (NOTE: No dog under the age of 6 mos will be homed with a family comprised of children 10 yrs or younger unless there is a fully secured fenced-in property or 10’x10’ sheltered kennel.) a. Type of fence: b. Height of fence: c. In good repair? ( Y ( N d. If you do not have a fenced yard, what arrangements do you plan to make for exercise and toilet duties? 6. Does the property have a swimming pool? ( Y ( N ------------------------------------------------------------------------------------------------------------ Caring for Your Dog: 1. Do you realize adopting a pet for its lifetime is a commitment than can span up to 15 years or more (depending upon the breed/mix)? This commitment involves food, shelter, health care and sometimes boarding and transportation fees to stay with his/her family. ( Y ( N 2. Do you understand animals, like humans, require routine vaccinations, health exams, and treatment for illness as well as emergency care? ( Y ( N 3. Do you have the financial means to attend to these requirements? ( Y ( N 4. Animals are as individual as people. Are you willing to expend the time and effort helping this pet adjust to your home and lifestyle? ( Y ( N How much time? 5. Will you have time to give your pet daily companionship? ( Y ( N How much time/day? 6. Is someone at home during the day? ( Y ( N Who/Age? Who/Age? 7. Where will the dog be when you are at home during the day? (“X” all that apply) ( Loose Indoors ( Loose outdoors in fenced yard ( Crate ( Basement ( Tied or chained outside ( Garage ( Kennel Run ( Other (describe) 8. Where will the dog be when you are away from home during the day? (“X” all that apply) ( Loose Indoors ( Loose outdoors in fenced yard ( Crate ( Basement ( Tied or chained outside ( Garage ( Kennel Run ( Other (describe) 9. Is someone at home during the night? ( Y ( N Who/Age? Who/Age? 10. Where will the dog spend the night? (“X” all that apply) ( Loose Indoors ( Loose outdoors in fenced yard ( Crate ( Basement ( Tied or chained outside ( Garage ( Kennel Run ( Other (describe) 11. How many hours, on average, will the dog spend alone? 12. Who will have primary responsibility for the dog? 13. Should the primary caregiver become incapacitated or is unable to continue caring for the animal, who will take responsibility to properly care for the pet? 14. What supplies do you have for this animal? 15. If you move, what will you do with this dog? 16. If the dog became destructive, what would you do? 17. Under what circumstances would you not keep this pet: 18. Would you be willing to return any AFTA-adopted dog to AFTA if you are unable to keep him/her? (if “no,” why?) ( Y ( N --------------------------------------------------------------------------------------------------------------- Your Pet Ownership History: 1. Do you own any other pets? ( Y ( N 2. Provide name(s), species, breed(s), sex(es), and age(s) of each: Name Species Breed Sex Age ______________ ______________ _______________ _____ __________ ______________ ______________ _______________ _____ __________ ______________ ______________ _______________ _____ __________ ______________ ______________ _______________ _____ __________ ______________ ______________ _______________ _____ __________ 3. Are all your pets spayed or neutered? ( Y ( N (if “no,” please explain why) 4. Please list any veterinarian(s) used for current or former pets. (If you do not have a veterinary reference, please provide the name, telephone number and email address of a second Personal Reference.) Veterinarian Name: Address: Phone: Veterinarian Name: Address: Phone: or Personal Reference Name Phone Email 5. How many pets have you owned in the past 5 years? a. Type of pet(s): b. How/Why obtained: 6. If you no longer have them, please give details explaining what happened to them: 7. If you have had a pet die at an early age or have ever lost a pet, please provide details: 8. Have you ever given a pet up for adoption or euthanized (“put to sleep”) a pet? (if “yes,” why?) 9. Has the applicant, any member of the applicant’s household, or anyone with access to where the dog will reside ever been charged or convicted of cruelty to or neglect of animals? ( Y ( N --------------------------------------------------------------------------------------------------------------- Pre-Approval Information Upon approval, an AFTA Adoption Agreement will be completed. Additionally, the adopters are hereby informed: 1. Approved adoption applications require a deposit of $100 within three (3) days via Paypal, personal check or money order made to the payment of All For The Animals, Inc. Please do NOT send a deposit until you have been instructed to do so after your telephone interview. 2. Full adoption fees are: $225 for adults and $350 for puppies. These fees help defray the costs of foster care (e.g.: food, veterinary attention, etc.) and transportation fees. 3. The adopter(s) is/are required to bring his/her dog to a veterinarian within 48 hours for a post-adoption physical and to purchase heartworm preventative. __________Initial __________Initial (type in initials) 4. The adopter(s) understand and concur with AFTA’s return policy which states: Any dog or puppy adopted from AFTA will be returned to AFTA according to the following guidelines-- a. The AFTA Adoption Coordinator will be informed in writing of the owner’s desire to return the animal in the event *unusual circumstances prevent said individual from honoring his/her obligation to the lifetime care of this animal; b. An AFTA Termination form will be completed, c. The dog will either remain in the adopter’s(‘) care as a foster family until a new adoptive family can be found, OR the individual(s) named above on this contract shall pay, in advance, minimally 2 weeks boarding fees., and d. The owner(s) will NOT receive a refund of the adoption fee. __________Initial __________Initial (type initials) *”unusual” circumstances do NOT include change in family status due to marriage/divorce; birth/adoption of children; children (who the pet befriended) moving away from the household; job reassignment; airline pet travel embargo; unwillingness to transport the animal via ground transportation or to locate pet-friendly transient quarters; inability to secure pet-friendly housing; or poor financial planning. How did you learn about us? The information supplied is correct, truthful and complete to the best of my/our knowledge. This form will be held on file for at least 7 years. Signature: ____________________________ Date: ____________________________ Signature: ____________________________ Date: ____________________________ (Please type complete names in the “Signature” space above. Signatures will be required at the time of the adoption.) Thank you for your application. All For The Animals, Inc. c/o 20 Homestead Rd Sagamore Beach Ma 02562 www.AllForTheAnimals.org AFTAInc@hotmail.com Page 1 of 9