City, State, Zip Code
How did you hear of FIDO's Companion, Inc.?
Met us at an event
Name of pet interested in adopting:
Why are you interested in this dog?
Who made the decision to adopt a dog?
Activity level you are looking for:
1 Low Activity Level
2 Low-Medium Activity Level
3 Medium Activity Level
4 Medium-High Activity Level
5 High Activity Level
Hours dog will be left home alone:
Place pet kept when home alone?
Percent of time pet kept outdoors:
Ability to work with housetraining:
I agree to work on housetraining
Unable to work on housetraining
Housetraining techniques you'll use:
Reasonable monthly pet expenses:
Current number of pets you have:
Types of pets you have (ie: dog, cat):
Is it ok to leave pet outside alone?
Yes it is ok
No it isn't ok
It depends on the circumstances
Under what circumstances is it ok?
Pet Id you'll have on your pet:
Collar embroidered w/ phone#
Information Tag (Pet ID Tag)
# of pets you've had in last 5 yrs?
Where are those pets now?
Reasons you'd surrender a pet:
Moving & can't take pet with you
Too much shedding
Aggression toward humans
Aggression toward other animals
Kids lost interest in pet
Pet not housebroken
Not Getting Along with Other Pets
Not Getting Along with Kids
Increased Work Hours
Ever given away a pet?
If yes, please explain "why":
Ever apply for a rescue pet before?
If yes, name of rescue(s):
Did you adopt from them?
If "no" explain "why":
Anyone in home have allergies?
If "yes" indicate allergic to:
Small Animals (gerbils, etc)
Will you take pet to obedience class?
Your type of residence:
Mobile Home (Rent)
Mobile Home (Own)
House Boat (Rent)
House Boat (Own)
If renting name of landlord:
Landlord phone number:
# of and ages of family members in home:
Type of fence:
Yard isn't fenced in
6' privacy fence
5' privacy fence
4' privacy fence
6' chain link
5' chain link
4' chain link
6' iron fence
5' iron fence
4' iron fence
Exercise you'll provide if no fence:
Name of current vet:
Phone number of vet:
PLEASE NOTE: Contact your vet and give permission for FIDO
to call in and do a vet reference.
If you do not keep your current or past animals up to date on vaccinations
or heartworm your application will be denied.
1st personal reference (Name & Ph#):
2nd personal reference (Name & Ph#):
Do you object to a home visit?
No, we don't object to a home visit
Yes, we object to a home visit
"Digital Signature" (initial here):
Click only once. Submit may take some time to finish.