DOG ADOPTION APPLICATION

Your Name:
E-Mail:
Year-Round Address & Telephone
PO Box (if applicable):
Address:
City:
State:
Zip:
Phone:
Alternate/Summer Address & Telephone
Address:
City:
State:
Zip:
Phone:
Occupation:
Do you live in a: House    Apartment
Do you: Own    Rent
If you rent, do you have your landlord's
permission to own a pet? 		Yes    No
How long have you been at your current residence?:    Years     Months
If you rent, please provide landlord's name and phone number:
What type of dog do you want? (e.g. Breed, size, age, sex, etc.):
Who is this pet for?:
# Children in your home & Ages:
What type of dog will it be? Indoor     Outdoor   Child's Pet
Watch Dog   Other:
Do you have a fenced-in yard? Yes    No
How will your dog be confined while outdoors?
How many hours per day will your dog be left alone?
Where will you leave it during that time?
Veterinarian Name:
Veterinarian Phone #:
Would you object to an ARF representative visiting your dog in its new home? Yes    No
Are you willing and able to accept financial responsibility for annual vaccines, check-ups and emergency medical care? Yes    No
Pets Currently In Your Home
Do you have any other pets now? Yes    No
# of Cats:    # of Dogs:

Dog #1:
Breed:  Age:
Sex:  Male   Female    Neutered:  Yes    No

Dog #2:
Breed:  Age:
Sex:  Male   Female    Neutered:  Yes    No

Cat #1:
# of Years Owned:  Age:
Sex:  Male   Female    Neutered:  Yes    No

Cat #2:
# of Years Owned:  Age:
Sex:  Male   Female    Neutered:  Yes    No

Other Pets? Yes    No
Please Explain:
Have each of your pets been to the veterinarian within the last 12 months? Yes    No
If you do not have a pet now, have you ever had a pet? Yes    No
If yes, what happened to them?
Have you ever adopted from ARF before? Yes    No
If yes, what year?   Cat?    Dog?
How did you hear about ARF? Friend     ARF Adopter 
Internet Newpaper/Magazine   Radio











Animal Rescue Fund of the Hamptons, Inc.
Daniel's Hole Road - PO Box 901 - Wainscott, NY 11975
Telephone: 631-537-0400 - Fax: 631-537-1759
info@arfhamptons.org
Founded for the Welfare of Animals
We are a tax exempt charitable organization under
Section 501(c)(3) of the Internal Revenue Code.

Selected artwork: © Susan J. Halbower
Site By: Hamptons Online