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Fill out an adoption survey
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Full Name
*
Address
*
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State
Zip Code
Birthdate
*
Phone
*
Email
*
Employer
Occupation
List the names of all adults (over 18) in your home
*
List the names and ages of all children in your home
*
What type of home do you live in?
*
Apartment
House (rent)
House (own)
Condo/Townhouse (rent)
Condo/Townhouse (own)
Other
How long have you been at this address?
*
If you rent, have you spoken to your landlord about their pet policy?
What is the activity level in your home?
*
I rarely have visitors
I have occasional visitors
I frequently have visitors
I never know when visitors will arrive
Please describe all of the other pets in your home
*
What kinds of activities will you do with your new dog?
*
Does your community have leash laws?
*
Yes
No
I don't know
Please check all of the qualities you want in your dog
*
Independent
Athletic
Likes other dogs
Confident
Affectionate
Protective
Very active
Enjoys young children
House-trained
Likes cats
Good with livestock
Moderately active
Able to live outdoors
Knows to stay in own yard
If you are applying for a specific dog, please state the dog's name
Do you have a gender preference?
*
Female
Male
No preference
Preferred age
*
Under 4 months
4 months - 1 year
1 - 3 years
3-7 years
7 years or older
Doesn't matter
Where will the dog be kept when you are away from home?
*
Free in the house
Yard
Yard on a tie-out
Pen with a dog house
Crate
Crate at first, then free in the house if appropriate
Dog-proof room
basement or garage
Doggie day care
Other
If you have a fence, what type of fence is it?
*
Not applicable
Solid wood
Woven wire
barbed wire
Electric
Invisible
Picket
If you do not have a fence, are you considering installing one (having a fence is not a requirement for adopting)
*
Yes
No
Are you considering attending dog training classes (this is not a requirement for adopting)
*
Yes
No
How did you hear about AFF?
Additional comments
Signature (type your full name)
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