1202 East Patrick Street, Suite 13A | Frederick, MD 21701 | 301.663.5855
The Animal Welfare League of Frederick County is a non-profit 501(c) (3), all volunteer organization.
DOG ADOPTION APPLICATION INSTRUCTIONS
This adoption form is to be completed using Microsoft Word. The form is designed to guide you from field to field by using either the tab key and/or the mouse click. As you complete the form, you will be completing three different types of data fields. These fields are:
Text Boxes allow you to enter your own information. Most of the Text Boxes allow unlimited entry. Others will limit you to a predetermined number of characters (e.g. State Text Boxes only allow 2 characters.
Check Boxes are used to provide for yes/no responses. To check a particular box, simply click your mouse button (left click) over the appropriate box and an “X” will be inserted. If you tab to the box, hitting the space bar will accomplish the same thing.
Finally, there are “drop down” boxes that allow you to select the best response from a set of pre-determined choices. Simply click on your choice and it will be inserted into the field.
Where you are asked to ‘initial’ or ‘sign’ the form, simply key (type) your response in the space provided. When you have completed the form, you need to save and email it.
SAVING THE FILE:
To facilitate the processing of your application, you need to save the completed form on your computer and then attach it to an email.
The file name you need to save the form as is comprised of three elements. These elements include your last name followed by a hyphen, the name of the animal you are applying for, and the file extension for a Word document which is “.doc”. Here is an example. If Ms. Smith is submitting an application for Buddy, she would save her completed file as: Smith-Buddy.doc. This same file name should also be used as the “Subject” in your email to us.
SUBMITTING YOUR APPLICATION
When you are ready to submit your application and begin the adoption process, send an email to the
AWLFC volunteer that is handling the adoption of the animal you are considering. The volunteer’s name and address can be found in the description of the animal. Don’t forget to use your last-pet’s name.doc in the Subject line of your email (SUBJECT: smith-buddy.doc).
1202 East Patrick Street, Suite 13A | Frederick, MD 21701 | 301.663.5855
The Animal Welfare League of Frederick County is a non-profit 501(c) (3), all volunteer organization.
DOG ADOPTION APPLICATION
It is the responsibility of the Animal Welfare League of Frederick County (AWLFC) to place this dog in an environment compatible with its needs and to ensure the adoption is in the best interest of both the animal and the adopter. We realize this application document and the adoption process are lengthy; please understand that we are committed to placing this dog in a loving home where it will remain for its lifetime. Please complete this application in its entirety.
Thank you.
Date: Name(s) of Dog(s) to be Adopted:
Breed(s):
Your Name(s):
Address:
City: County: St: Zip:
Home Phone: () - Cell: () - Work: () -
Your Email:
ABOUT YOU AND YOUR HOME
Your Age? Are you employed? YES NO
If yes, where? How Long? Years Months
Do you operate a home-based business? YES NO
How long have you lived at your current address? Years Months
Do you own or rent? Own Rent
If you rent, please provide you landlord’s name and phone or a copy of your lease which indicates that you are allowed to have a pet. Name? Phone? () -
What type of home do you have? Single Family Townhouse Apartment Farm Other (please explain)
Do you have a fenced yard? YES NO If yes, how large? and describe (4’ chain link, 6’ wood, etc.):
Do you understand that you may be required to purchase additional homeowner’s and/or liability insurance if you adopt certain breeds of dogs? YES NO
If you were to move from this home, what would you do with your pet?
How would you characterize your home? Quiet Moderately Active Active
Please list all people who live in your home (include children):
Name / Age / Relationship (spouse, child, other) / Pet Allergies? / Has this person visited the Pet?-- SelfSpouseChildRoommateLife PartnerOther / YES No / YES No
-- SelfSpouseChildRoommateLife PartnerOther / YES No / YES No
-- SelfSpouseChildRoommateLife PartnerOther / YES No / YES No
-- SelfSpouseChildRoommateLife PartnerOther / YES No / YES No
-- SelfSpouseChildRoommateLife PartnerOther / YES No / YES No
If yes to “Pet Allergies”, explain how this will be addressed given that you wish to adopt a dog.
ABOUT YOUR CURRENT AND PREVIOUS PETS
Please tell us about your CURRENT pets.
Species(Dog, cat, etc.) / Breed / Age / Gender / Altered?
(Check if YES) / How long have you had this pet? / Where did you get this pet?
-- MaleFemale / YES
-- MaleFemale / YES
-- MaleFemale / YES
-- MaleFemale / YES
-- MaleFemale / YES
-- MaleFemale / Yes
Please tell us about your PREVIOUS pets. (Last 5 years.)
Species(Dog, cat, etc.) / Breed / Age / Gender / How long did you have this
pet? / What happened to it??
ABOUT ADOPTING THIS DOG
Why do you want to adopt this animal (companion, gift, buddy for other pet, etc.)?
How did you find out about this animal? (Check all that apply.)
Adoption Event Friend Newspaper Petfinder.com Other
How long have you been thinking about adopting a dog?
Tell us about the traits (energy level, size, temperament, fur type, etc.) you seek in a dog.
What research have you done to prepare for being the guardian of this animal?
What preparations have you made to bring this pet home?
How much do you estimate it will cost to care for this animal each year?
Who will have the primary responsibility for the care of this animal?
While children can participate in the care of family pets, it is unrealistic to expect children of any age to assume complete responsibility for an animal. An adult in the home must take ultimate responsibility to ensure the pet is well cared for and socialized. Are you prepared to oversee the care of this animal and to take responsibility for this animal even if your child becomes disinterested? Yes No Your initials:
How many hours per day will this animal be home alone? Where would dog be kept?
How will you provide this dog with exercise?
How do you plan to train this dog?
This dog or puppy may not be housetrained. Will you be able to tolerate accidents and are you willing and able to spend the time required to train this dog?
Where will this animal sleep at night?
Who will care for this pet when you go on vacation?
Under what circumstances would you give up this animal? Please check ALL that apply. And please be honest – this won’t necessarily disqualify you from adopting but it will give us a chance to discuss it with you and perhaps give you options should this event arise.
We need to relocate.
We have a baby.
The animal requires expensive veterinary care. What would be too much?
Someone in the family becomes allergic.
Someone in the family becomes very ill.
There is a divorce in the family.
The animal’s main caretaker leaves (for college, another job, called for military duty, etc.)
The animal does not get along with other pets.
The animal becomes incontinent or forgets training.
The animal has separation anxiety.
The animal becomes aggressive towards a family member.
Please provide your veterinarian’s name and phone number:
Name: Phone: () -
How often did/does your pet(s) visit the veterinarian?
Are you working with any other rescue groups to adopt a dog? YES NO
How soon are you prepared to bring this dog into your home?
REFERENCES
Please provide the names, phone number, and email address of three references, two of which
are not family members.
Name / Email Address / Phone Number1. / () -
2. / () -
3. / () -
I understand that the Animal Welfare League of Frederick County (AWLFC) reserves the right to refuse adoption to anyone if it is in the best interest of the animal and/or applicant. I certify that the above information is true and complete and understand that it is subject to verification by AWLFC. Falsification of any information will render the application void. I further understand that AWLFC reserves the right to perform a home visit prior to approving this adoption application, as well as follow up, by phone or by a home visit, on any adoption to ensure compliance with the adoption contract. Further, I give my permission for AWLFC to contact my veterinarian (listed above).
Signed (type your name on a form to be transmitted electronically):
Date:
This application is valid for 30 days and only for the animal(s) named above.
Thank you for looking to the Animal Welfare League of Frederick County for your new family member. With this adoption, you are saving not only this dog’s life, but making room for us to bring another dog into foster care, saving its life, too. We thank you!
For AWLFC Use Only
Interviewed by: ______Date: ______
Approved: ______YES NO Comments: ______
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