DOG ADOPTION APPLICATION

Friends of Homeless Animals (www.foha.org) is located in Aldie, VA and is not affiliated with Friends of Homeless Animals - Rhode Island (www.fohari.org).

Please read the information below BEFORE completing this application:

This application is the initial step in the adoption process and does not guarantee an adoption will occur.

This application will be used as your application to adopt a dog when you visit our facility, so please complete each answer with as much detail as required to explain your answer.

The adoption fee for a dog 1 year old and up is $325. The fee for a puppy (under 1 year) is $375.

All members of your household (both human and canine) must meet any dog in which you are interested before your application will become active and be processed.

Please read each question carefully and provide detailed answers.

Unless you plan to be the sole guardian, the co-applicant's contact information and past pet experiencef must be listed on this application. All other questions must be answered jointly.

All questions on the application must be answered completely or your application will not be processed. If a question does not pertain to you, please respond with N/A.

Please do not navigate off this page before submitting the application or your information will be lost.

Top of Form

Are you interested in a specific dog or dogs? If yes, please list the name(s) here. If no, please leave blank.

Has everyone living in your home already met this dog?

Where did you hear about FOHA?

Are you a former FOHA adopter?

Do you live in the Washington, D.C. Metro area?

APPLICANT #1 INFORMATION:

First Name:

Middle Name:

Last Name:

Street Address:

City:   State:   Zip:

How long have you lived at your current address?

Home Phone:

Work Phone:

Cell Phone:

Email:

Age:

If we have questions on your application and need to contact you by phone, what is the best contact number and best time to reach you?

APPLICANT #2 INFORMATION:

Unless you plan to be the sole adopter of your new pet, Applicant 2's contact information must be listed on this application.

First Name:

Middle Name:

Last Name:

Street Address (if different than above):

City:   State:   Zip:

Home Phone:

Work Phone:

Cell Phone:

Email:

Age:

HOUSEHOLD INFORMATION:

How many persons, including children, reside in your home?

Please provide the following information for EACH person living in your home

Name Age Relationship
Person 1:

Person 2:

Person 3:

Person 4:

Person 5:

Person 6:

In what style home do you live?

Single Family Home

Townhouse

Apartment

Condo

Mobile Home

Other:

Do you own or rent your home?

Do you have any breed or weight restrictions where you live? If yes, what are they? Please note that the home visitor will need to see a copy of your lease at the home visit.

Is your front or back yard completely fenced in?

Please describe your fence. How tall is it? What is it made from?

CURRENT/PAST PET EXPERIENCE:

Will this be the first dog you have had on your own?

Yes

No

CURRENT AND PAST PETS: Please tell us about all the pets you have owned, including those currently living in your home (past 10 years only). Please list each pet on a separate line below.

Pets:

Pet 1:

Pet 2:

Pet 3:

Pet 4:

Pet 5:

Pet 6:

Pet 7:

Pet 8:

If any of the pets above are no longer living with you, please tell us where they are now and include in your answer the information below.

> If a pet is deceased, please include when they died and from what.

> If you gave away or surrendered a pet to a shelter, please explain the circumstances that forced you to give up your pet, to whom you gave it (include shelter's name and location) and when.

Are there other animals that live in your home that belong to someone else (roommate, tennant, etc.)?

If yes, what is the species (cat, dog, etc.) of the animal, as well as the breed, weight, sex and age?

Have each of your pets, both past and present, been spayed or neutered?

Yes

No

Do not Know

If not, why?

Have each of your pets (cats and dogs), both past and present, been kept current on vaccinations? Please be advised that FOHA will confirm this information with the veterinarian.

Yes

No

Do not Know

If not, why?

Have you ever surrendered a pet to a shelter?

Yes

No

If yes, why did you have to give up your pet? What was the name of the shelter where you took the pet and where is it located? In what year did this happen?

Have you ever given a pet away?

Yes

No

If yes, why did you have to give up your pet? To whom was your pet given? In what year did this happen?

Have you ever had to have one of your pets euthanized?

Yes

No

If yes, what were the circumstances?

Please tell us the name and contact information for the vet(s) you use or have used for your animals (past 10 years only). If you have/had more than one vet, please include which animals are seen by each vet.

Current Animals and contact information for treating vet:

Previous animals and contact information for treating vet:

WHAT ARE YOU LOOKING FOR IN A NEW DOG?

Why do you want to adopt a dog?

Companion

Hunting

Breeding

Protection

Alert

Gift

Other:

What type of dog are you looking for?

playful and energetic

laid back and calm

independent

affectionate

confident

good with kids

good with other dogs

good with cats

If you have a cat, has your cat interacted or lived with a dog before?

Yes

No

N/A

Please describe in detail what you are looking for in a dog?

Are there any behaviors you won't tolerate in your new dog?

What methods will you use to discourage or prevent inappropriate behaviors in the dog?

What methods will you use to encourage and reinforce appropriate behaviors in the dog?

Many dogs require leash training. What method of training will you provide to teach your dog leash manners?

training class

halti head harness

prong collar

gentle leader harness

choke collar

electric shock collar

Other:

PROVIDING FOR THE NEW DOG:

Where will the dog be kept when you are home?

outside

in a doghouse outside

in a crate

in the garage

in the unfinished basement

in the finished basement

free run of the home

Other:

If you chose "in a crate" above, please tell us your plan for crating while you are home, including how many hours the dog will be crated while you are home. Will the dog have a break during this time?

Where will the dog be kept while you are out of the home?

outside

in a doghouse outside

in a crate

in the garage

in the unfinished basement

in the finished basement

free run of the home

Other:

If you chose "in a crate" above, please tell us your plan for crating while you are out. Will the dog have a break during this time?

Please describe where the dog will sleep.

outside

in a doghouse outside

in a crate

in the garage

in the unfinished basement

in the finished basement

free run of the home

Other:

If you chose "in a crate" above, please tell us your plan for crating at night. Will the dog have a break during this time?

During what hours does your job or other commitment keep you away from home each day, including commuting time?

Do you have a dog door?

Yes

No

How will you provide for the dog to get outside while you are gone?

We cannot guarantee our dogs are housetrained. What method will you use to housetrain your new dog?

Are there times when the dog will be tied up?

Yes

No

If yes, please explain:

Will the dog spend any time in the garage?

Yes

No

If yes, please explain:

Do you drive a pickup truck with an open bed?

Yes

No

If yes, will the dog be allowed to ride in the back?

Yes

No

If yes, please explain:

Who will provide the daily exercise for the dog?

What type of exercise will you provide for the dog and how often? Please describe your daily exercise routine in detail. How many walks a day?

Will you keep the dog up-to-date on vaccinations and heartworm preventative?

Yes

No

If you go away for a few days, or on a vacation, who will take care of the dog?

If you move, what will happen to the dog?

Prior to this application, have you ever applied to FOHA to adopt an animal?

Yes

No

What was the result of your application? [If you adopted a companion from us, please include the animal's name while at FOHA and the year you adopted.]

Have you ever surrendered n animal to FOHA?

Yes

No

If yes, please explain in detail:

Are you willing to have a FOHA representative come to see where the dog will be living?

Yes

No

If no, why not?

Adopting a dog is a life-changing lifetime commitment. Are you ready to take responsibility of this dog for the rest of its life, which could be 10 to 15 years or longer?

Yes

No

If no, what is your plan for the dog?

Are you currently working with any other shelters or rescues to adopt a dog? If yes, which ones?

Additional Comments?

FRIENDS OF HOMELESS ANIMALS RESERVES THE RIGHT
TO REFUSE PLACEMENT OF ANY ANIMAL FOR ANY REASON.

<h3>FRIENDS OF HOMELESS ANIMALS RESERVES THE RIGHT TO REFUSE THE PLACEMENT OF ANY ANIMAL FOR ANY REASON.</h3>

HOME VISIT FOR (DOG NAME):________________________________________________________

CAT TEST NEEDED? _________________________________________________________________

BEST DAY/TIME FOR HOME VISIT?_____________________________________________________ </h3></div>

Date of Application Review:_______________________

I am interested in:

Has everyone living in the home already met ?

FOHA volunteer reviewing this application:______________________

Name of volunteer who worked with family in choosing this dog, if other than reviewer:______________________

<table>

<tr>

<th>APPLICANT 1 INFORMATION:</th>

<th>APPLICANT 2 INFORMATION:</th>

</tr>

<tr>

<tr>

<td>Address:  </td>

<td>Address:  </td></tr>

<tr>

<td>Address:   </td>

<td>Address:   </td></tr>

<tr>

<td>Home Phone:   </td>

<td>Home Phone:   </td></tr>

<tr>

<td>Work Phone:   </td>

<td>Work Phone:   </td></tr>

<tr>

<td>Cell Phone:   </td>

<td>Cell Phone:   </td></tr>

<tr>

<td>Email:    </td>

<td>Email:    </td></tr>

<tr>

<tr>

</table>

<Adoption Form Received - Details Below:

Do you live within the Washington DC Metro area?

If we have questions on your application and need to contact you via phone, what is the best contact number and best time to reach you?

Where did you hear about FOHA?

Are you a former FOHA adopter?

How long have you lived at your current address?

HOUSEHOLD INFORMATION:

In what style home do you live?

Do you own or rent your home?

Do you have any breed or weight restrictions in your home? If yes, what are they.

Is your front or back yard completely fenced in?     

Please describe your fence. How tall is it? What is it made from?      

How many persons reside in your home?

Please provide the following information for each person in your home.

NAME / AGE / RELATIONSHIP TO APPLICANT

/ /

/ /

APPLICANT AND CO-APPLICANT CURRENT/PAST PET EXPERIENCE:

APPLICANT:

Will this be the first dog you have had on your own?     

Please provide the following information for ALL PETS you currently own or have owned as an adult (past 10 years only).

SPECIES / NAME / BREED / AGE / SEX / WHERE ARE THEY NOW

/ / / / /

For each pet above that is no longer with you -- whether deceased, given away or surrendered -- please tell us:

- if pet is deceased, how they died and when;

- if pet was given away or surrendered to a shelter, why pet was given up, to whom or what facility it was given and when.

Are there other animals that live in your home that belong to someone else (roommate, tennant, etc.)

If yes, describe the animal(s), including the type of animal, sex, age and whether it is spayed or neutered.

Have all your pets, past and present, been spayed or neutered?     

If not, why?     

Are or were all your pets current on vaccinations?     

If not, why?     

Have you ever surrendered a pet to a shelter?     

If yes, please provide as much information as possible about the circumstances, including the name of the shelter and how along ago this happened?      

Have you ever given an animal away?     

If yes, please provide as much information as possible about the circumstances.     

Have you ever had a pet euthanized?     

If yes, what were the circumstances?    

Please list the name and phone number for your current veterinarian and all veterinarians you have used in the past, as well. Also include which animals were seen by each veterinarian.

Name and phone number of current veterinarian:     

Name and phone number of previous veterinarians:     

WHAT ARE YOU LOOKING FOR IN A NEW DOG?

Why do you want to adopt a dog?     

Describe in detail what you are looking for in your new dog.

If you have a cat, has your cat interacted or lived with a dog before?

Are there any behaviors you will not tolerate in your new dog?

What methods will you use to discourage or prevent inappropriate behaviors in your new dog?

What methods will you use to encourage and reinforce appropriate behaviors in your new dog?

Many dogs require leash training. What method of training will you provide to teach your dog leash manners?

PROVIDING FOR THE NEW DOG:

Where will the dog be kept when you are home?      

Where will the dog be kept while you are out?      

Where will the dog sleep?      

How many hours each day will the dog be without human companionship?      

Do you have a dog door?     

How will you provide for the dog to get outside while you are gone?     

If your new companion is not housetrained, what method will you use to housetrain?     

Who will provide the daily exercise for your new dog?

What type of exercise will you provide for your new dog and how often? Please describe your daily exercise routine in detail. How many walks per day?

If you move, what will happen to the dog?     

Are you willing to have a representative of FOHA come to see where the dog will be living?

If no, explain:

Any additional comments?

TO BE COMPLETED BY ADOPTION LEAD:

1. Have applicants reviewed FOHA dog's profile?     ☐ Yes; ☐ No

2. Have all persons living in the home met the FOHA dog?     ☐ Yes; ☐ No    If no, application cannot move forward until that happens.

3. If applicants currently have a dog, has the current dog met the FOHA dog?     ☐ Yes; ☐ No

4. If applicant's have no fence, are they aware that FOHA Adoption Contract states that FOHA dog must be leashed when not in an enclosed area?     ☐ Yes; ☐ No

5. If applicant is renting their home, please let them know that home visitor will need to see a copy of their lease at the home visit.

6. Please request that applicants contact their current/prior VET(s) as soon as possible and give them permission to speak with a FOHA representative.

REVIEWER REMINDERS/REQUESTS:

-- If applicants have a cat, FOHA dog will need to be cat-tested. Please be sure that is noted in the appropriate spot at the top of this application.

-- Please remind applicants that we can't "hold" dogs. If they can't pick up next weekend, the FOHA dog will remain available for adoption.

-- If you have additional information on applicants to share with home visitor, please include below. Use as much spaced as needed.

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