faithfulcompanionsform

Faithful Companions Dog Rescue Adoption Application

Name

Address

City

State

Zip Code

Please use the following format for phone numbers: 1234567890

Home Phone

Cell Phone

Email

Your DOB

What Dog Interests You?

Spouse/Partner's Name

Spouse/Partner - DOB

Children? Age?

Veterinarian's Name

Vet's Phone #

**VERY IMPORTANT!!! If you are interested in adopting, please call your vet and let them know that we will be calling for a reference. Thank you.

Rent or Own Home?

Own Rent

If you rent, landlord's name & phone #

How many hours each day will your dog be left alone?

When alone, where will your dog be kept?

Will your dog be able to run around the house or will it be in the garage, back yard, crated, etc.?

How many hours each day will your dog be outside?

When outside, where will your dog be fastened?

Where will your dog sleep at night?

Please list animals you owned in past 3 yrs. List breed, name, age, sex, spayed/neutered, where kept, what happened?

Please list two personal references with phone number.

I certify that the information I have supplied above is true and that any false statements may result in nullifying this application. I further understand that this application is the property of Faithful Companions Dog Rescue and will be retained by them. I also agree to contact a representative of the Faithful Companions Dog Rescue immediately for permission to return any animal I may adopt should I need to relinquish ownership of this animal at any time.

By typing my name, I certify that the information I have supplied above is true.

***Please note: Once we receive your application and you have been approved to adopt, we will put pending beside the dog’s name. You will have 24 hours to pay the adoption fee, or we will remove the pending status so others may have a chance to adopt the dog. The adoption fee MUST be paid in advance before we can transport the dog north.

Neither Faithful Companions Dog Rescue (FCDR) nor the rescue or shelter from which the adopted dog came, will be responsible for any health problems that arise after the adoption date. Standard protocol for each animal adopted has been provided, per our supporting veterinarians. Any dog that has been found to have any communicable health issues cannot travel to the northeast.

Do you understand that you are responsible for any unforeseen health issues that may arise after the adoption from FCDR?

Yes No

PLEASE READ WHAT THE FEE COVERS:

**neuter/spay (age appropriate)
**DA2PP, or similar distemper/parvo vaccinationn
**rabies vaccine (age appropriate)
**bordatella vaccine (kennel cough)
**interstate health certificate/pre-transport vet visit
**negative fecal
**worming
**heartworm test (over 6 months)
**flea, tick and heartworm preventative
**all dogs are either heartworm negative or have been treated for heartworm under the care of a veterinarian
**temperament test

**Please note: We cannot guarantee the authenticity of the breed or the size of the puppy (when full grown), as this information is given to us by the shelters and rescues with whom we work.

Our rescue doesn't have an actual shelter building in your area or mine. Therefore, it is not possible to meet the dogs and pups prior to their adoption. They are brought up north from the south on a USDA transporter.

Potty training is necessary for any dog of any age when acclimating to a new environment; please refer to www.aspca.org for some great basic tips for all dog owners when transitioning a new pet into the family.

Upon adoption, you will receive the transport schedule.

**VERY IMPORTANT!!! If you are interested in adopting, please call your vet and let them know that we will be calling for a reference. Thank you.

Email