Name
*
First Name
Last Name
Phone
*
(###)
###
####
Email
*
Your Date of Birth
*
MM
DD
YYYY
Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Type of Home
*
House
Apartment
Townhome
Mobile Home
Other
Do you rent or own?
*
Rent
Own
Do you have a fenced in yard?
*
Yes
No
Do you live in a high-traffic area (busy street, near a highway, etc.)?
*
Yes
No
If you were to adopt, where would the animal live?
*
Strictly Indoors
Strictly Outdoors
A mix of indoors and outdoors
How often and for how long will the animal be left alone?
*
Please list any other humans currently living in your house, must include names and ages
*
Please note: A valid phone number must be included for anyone living in your house that is over 18 years old. If you do not include this, your application will be denied.
Employer
*
Supervisor's Name
*
First Name
Last Name
Employer Phone
*
(###)
###
####
Why are you wanting to adopt?
*
A companion
Family pet
Guard / watch dog
A gift
Other
Have you ever owned a pet before?
*
Yes
No
Have you ever had to surrender or rehome an animal before?
*
Yes
No
Have you ever adopted an animal from Your Local Fur Mama before?
*
Yes
No
Do you currently have any other pets in your home?
*
Yes
No
Phone number of veterinary office
*
(###)
###
####
Personal Reference One
*
Must not be a family member
First Name
Last Name
Phone
*
(###)
###
####
Personal Reference Two
*
Must not be a family member
First Name
Last Name
Phone
*
(###)
###
####
Personal Reference Three
*
Must not be a family member
First Name
Last Name
Phone
*
(###)
###
####
Are you aware of the financial costs of owning an animal?
*
Yes
No
Do you commit to taking care of this animal, paying for all medical costs and everyday expenses for the rest of their lives? (Could be anywhere from 15 - 20 years)
*
Yes
No
What will you do if your life circumstances change (e.g., moving, changing jobs, financial hardship)?
*
I will find a way to keep the pet and adjust my life accordingly.
I will reach out to the organization for guidance and help.
I will rehome the animal with a responsible person.
Are you comfortable with the potential challenges that may come with an animal (e.g., accidents, medical treatments, behavioral issues)?
*
Yes
No
How do you plan to address potential behavioral problems such as separation anxiety, chewing, barking, etc.?
*
Professional trainer
Self-training
Unsure
Do you travel often for work or personal reasons?
*
Yes
No
Under no circumstances are you allowed to rehome this animal or leave it with any rescue or shelter. If the situation arises, you must contact Your Local Fur Mama (Abigale Madonia) immediately. Do you understand?
*
Yes
No
I certify that all information provided in this application is true and accurate to the best of my knowledge. I understand that any false information or omissions may result in denial of adoption or revocation of an adoption approval. I acknowledge that Your Local Fur Mama reserves the right to deny any application at their discretion, regardless of qualifications, as part of our mission to prioritize the health, safety, and well-being of our rescues and ensure the best possible match for each animal.
*
Please write your name below to signify you have read and understood the above statement
First Name
Last Name
