Friends for Seniors Applicatoin
Name of Dog
First Name
*
Last Name
*
Phone Number
*
Email Address
*
Date of Birth
*
Address
*
City
*
State
*
Zip Code
*
Are you in a financial position to provide adequate food, housing, and vet care?
*
No
Yes
Explain how you would handle an emergency vet visit.
*
Explain your plan for the animal if you are no longer able to care for him/her
*
Do you have other pets in the home? What kind? If not please put N/A
*
Dog
Cat
Do you have kids that visit on a regular basis?
*
No
Yes
Explain how you will handle a situation if your new animal does not get along with kids that come to visit
*
Do you understand that your new pet needs time to decompress and adjust to your home?
*
No
Yes
How much time will you give your new pet to adjust and what will you do to help with this adjustment period?
*
Do you have qualities that are important to you? Please check all mandatory qualities below:
No
Yes
Active
Lazy
Male
Female
Housebroken
Crate Trained
Leash Trained
Good with dogs
Good with cats
Good with kids
No physical or health issues
The Friends for Seniors program is a program for our senior (5+) animals and senior adopters (65+). We do waive the adoption fee for those approved to adopt through this program, but ask that you make a donation to the rescue in the name of the animal that you are adopting. Do you understand and agree?
*
No
Yes
Name of Vet
*
Vet Phone
*
Reference Name and Number
*
Reference Name and Number
*
Reference Name and Number
*