Name
*
First Name
Last Name
Phone
*
(###)
###
####
Email
*
Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Do you rent or own?
*
Rent
Own
If you rent, are you allowed to have pets?
Yes
No
Name of your landlord
First Name
Last Name
Phone number for your landlord
(###)
###
####
Your Date of Birth
*
MM
DD
YYYY
Employer
*
Supervisor's Name
*
First Name
Last Name
Employer Contact
*
(###)
###
####
Type of home
*
House
Apartment
Townhome
Mobile Home
Other
If you answered other to the above question, please describe.
Have you ever owned a pet before?
*
Yes
No
If you answered yes to the above question, please check the boxed below of the type of pets you have had experience with.
Have you ever had to surrender or rehome an animal before?
*
Yes
No
If you answered yes to the above question, please describe.
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
If you answered yes to the above question, please list their species, breed, and age.
Are your current animals spayed/neutered?
*
Yes
No
Phone of Current Veterinary Office.
*
(###)
###
####
Personal Reference One.
*
Must not be a family member
First Name
Last Name
Personal Reference Phone Number.
*
(###)
###
####
Personal Reference Phone Number
*
(###)
###
####
Personal Reference Three.
*
Must not be a family member
First Name
Last Name
Personal Reference Phone Number
*
(###)
###
####
If you were to foster, 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.
*
Please include names and ages. Yes, children do count!
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.
Do you have a fenced in yard?
*
Yes
No
What foster opportunities would you be interested in?
*
Please select all that may apply (all supplies, training and medical care are provided by YLFM).
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 Choi) immediately. Do you understand?
*
Yes
No
