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FOBAC Dog/Cat Adoption Form
Personal Information
E-Mail:*
Valid e-mail is required
First Name:*
Last Name:*
Spouse/Partner/Housemate Name:
Address Line 1:*
Address Line 2:
City:*
State:*
Choose a State
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South Carolina
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Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip Code:*
Occupation
How long have you lived at your current address?*
Marital Status:
Select Status
Single
Married
Divorced
Gender:
Select Gender
Male
Female
Date of Birth:
Month
January
February
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Day
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Primary Phone # :*
Secondary Phone #:
How many children live in the home:*
Ages:
How many adults live in the home :*
Do all adults work outside the home:*
Yes
No
Do you:*
Own your property
Rent your property
Live with your parents
If renting, does lease allow for pets?
Yes
No
If renting, please provide landlord`s name and telephone number:
Adoption Related Information
Which pet are you interested in?*
Where did you first see this pet?*
Color or breed preference (if any)*
What kind of pet do you want to adopt?*
'17' '99'
Choose Reason(s)
Cat
Kitten
Female
Male
Short Hair
Long Hair
Dog
Puppy
Small size (dog)
Medium size (dog)
Large size (dog)
Special needs
Choose multiple w/ Crtl key
Reason for adopting a cat or dog:*
'29' '99'
Choose Reason(s)
Companion for Myself/Family
Companion for Another Pet
Companion for Friend/Relative
Guard Dog
Hunting
Agility
Family Pet
Child`s Pet
Gift
Other
Choose multiple w/ Ctrl key
Do you have a fenced in yard?*
Yes
No
Do you currently own a pet?*
Yes
No
Please list all companion animals you currently have:
include type of pet & age
Name and phone number of Veterinarian (REQUIRED)
Where will this pet spend most of it`s time?*
Select spend time
Indoor Only
Mostly Indoor w/some Outdoor
Indoor/Outdoor
Mostly Outdoor w/some Indoor
Oudoor Only
How many hours a day will your new pet be without human companionship?*
Pets usually require minimum cost of $500 per year for veterinary care, food, and other related expenses.
Are you willing and able to afford these costs?*
Yes
No
Have you ever had to give up or find another home for a pet in the past?*
Yes
No
If yes, please explain?
Agree to home visit after 6 months:*
Yes
No
ADOPTION POLICY: ALL PETS WILL BE SPAYED OR NEUTERED BY DATE AGREED UPON AT TIME OF ADOPTION.
Contact information:
Friends of Berlin Animal Control
PO Box 1
Kensington, CT 06037
ph.860-828-5287
fobac.pets@yahoo.com
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