Adoption Application General InformationName* First Last Spouse/Partner's Name (if applicable) First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country How long have you lived at your current address?*Home Phone*Cell PhoneEmail* Enter Email Confirm Email Spouse/Partner's Email Enter Email Confirm Email Driver's License Number*Name/phone number of your veterinarian*What kind of pet are you interested in adopting?*DogCatPuppyKittenOccupationSpouse/Partner's OccupationIf you had a specific animal in mind...Did you see the cat/dog you are interested in on...ARF websiteFacebookName of animal.About the home you will provideMy/our reason for adopting this animal (select all that apply):* Companion Gift For children Hunting Other (If "Other" please specify.)*Who will be responsible for this pet?* Myself Partner Child All How many hours a day will this animal be alone?*Where will the animal live most of the time?*insideoutsideinside/outsideWhen inside, animal will be left: crated room basement loose tied full access to home When outside, animal will be left: fenced yard invisible fence tied runner walked loose supervised will not be allowed outside Number of adults in my home:Number of children in my home:(If there are children in the household, please list their ages.)*If any members of your family will not be present for this adoption, who are they and how do they feel about it?*Does anyone in the household have allergies?*NoYesType of residence*HouseApartment/CondoMobile HomeIf a rental, provide your landlord's name and phone #:Do you live near a heavily travelled road?*No.Yes.If so, which one?*Pet OwnershipHave you ever adopted a pet from Animal Rescue Foundation before?*No.Yes.If so, when and what happened to that pet?*Have you ever taken a pet to an animal shelter?*No.Yes.If yes, why did you take them to a shelter?*List pets that you currently have or have lost in the last three (3) years:NameTypeAgeSexSpayed/ NeuteredWhere is this pet now? (Click the + symbol at end of the line to add a new line.)If you moved and were unable to take your pet(s) to your new location, what would you do with them?*About the pet you would like to adoptGender of the pet?*No preference.MaleFemaleIf adopting a dog/puppy...What size dog are you interested in?No preferenceSmallMediumLargeDog's age?* Puppy Adult Senior n/a Are you willing to train this dog/puppy?NoYesAre you willing to housebreak this dog?NoYesHow long do you think it will take to housebreak?Adjustments to a new home can take a few weeks - are you willing to give this dog the needed adjustent time?NoYesIf adopting a cat/kitten...Do you intend to de-claw this cat?No.Yes.Will the cat have outside access?No.Yes.Cat's age?* Kitten Adult Senior n/a Adjustments to a new home can take a few weeks - are you willing to give this cat the needed adjustent time?NoYesHave you ever owned a cat before?NoYesWhere is that cat now?ConfirmationsPlease provide the names and phone numbers of two (2) personal references (not family members).*Additional comments to help us find the best pet for you.Would you like to join ARF's mailing list? Yes! Please add me to the list! AUTHORIZATION FOR RELEASE OF INFORMATION* I hereby give permission for the release of any information requested by the Animal Rescue Foundation regarding my past care of my pet(s). (Please contact your veterinarian to give them permission to release your pet information to assist Animal Rescue Foundation.) Be advised that it may take up to 5 (five) business days for review of your application - thank you for your interest in our animals! This iframe contains the logic required to handle Ajax powered Gravity Forms.