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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:*
Zip Code:*
Occupation
How long have you lived at your current address?*
Marital Status:
Gender:
Date of Birth:
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?*Choose multiple w/ Crtl key
Reason for adopting a cat or dog:*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?*
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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