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Dog Adoption Application
Animal Rescue Fund of the Hamptons
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dog adoption application
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Contact Information
First Name:
*
Last Name:
*
Email:
*
Address Line 1:
*
Address Line 2:
City:
*
State:
*
-- please make a selection --
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Not in USA
ZIP/Postal Code:
*
Phone:
*
Cell Phone:
Alternate/Summer Address Line 1:
Alternate/Summer Address Line 2:
Alternate/Summer Address City:
Alternate/Summer Address State:
Alternate/Summer Address Zip:
Alternate/Summer Phone:
Occupation:
*
Who is this pet for?:
*
Do you live in a:
*
-- please make a selection --
House
Apartment
Do you:
*
-- please make a selection --
Own
Rent
How long have you been at your current residence? (Years/Months):
*
If you rent, do you have your landlord's permission to own a pet?:
-- please make a selection --
Yes
No
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.):
*
What type of dog will it be?:
*
-- please make a selection --
Indoor
Outdoor
Child's Pet
Watch Dog
Other
Do you have a fenced-in yard?:
*
-- please make a selection --
Yes
No
How many hours per day will
your dog be left alone?:
*
Where will you leave
it during that time?:
*
Veterinarian Name:
Veterinarian Phone #:
Number of children in
your home & ages:
*
Would you object to an
ARF representative visiting
your dog in its new home?:
*
-- please make a selection --
Yes
No
Are you willing and able to
accept financial responsibility
for annual shots, check-ups
and emergency medical care?:
*
-- please make a selection --
Yes
No
How did you hear about us?:
-- please make a selection --
Friend
Internet
ARF Adopter
Newspaper/Magazine
Radio
Your Pets
# Dogs currently in your home:
*
# Cats currently in your home:
*
Dog #1 Name:
Dog #1 Breed:
Dog #1 Age:
Dog #1 Neutered?:
-- please make a selection --
Yes
No
Dog #2 Name:
Dog #2 Breed:
Dog #2 Age:
Dog #2 Neutered?:
-- please make a selection --
Yes
No
Cat #1 Name:
Cat #1 Age:
Cat #1 Neutered?:
-- please make a selection --
Yes
No
Cat #2 Name:
Cat #2 Age:
Cat #2 Neutered?:
-- please make a selection --
Yes
No
Have each of your pets
been to the veterinarian
within the last 12 months?:
-- please make a selection --
Yes
No
Some of them
N/A Have no pets now
Do you have other pets?:
*
-- please make a selection --
Yes
No
If yes, what are they?:
If you don't have a pet now
have you ever had a pet?:
-- please make a selection --
Yes
No
If yes, what were they and
what happened to them?:
Have you adopted
from ARF before?:
*
-- please make a selection --
Yes
No
If yes, was it a cat or dog?:
-- please make a selection --
Cat
Dog
Both
What year did you adopt?:
How did you hear about ARF?:
-- please make a selection --
Friend
Online
ARF Adopter
Newspaper/Magazine
Radio
Other
Stay Informed!
Yes, I want to receive updates on ARF news and events.
Thank you for your interest in adopting a dog at ARF. One of our Adoption Coordinators will contact you shortly.
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