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The Fort-Fortitudine Vincimus Rescue Center
Adoption Application
Thank you for your interest in adopting an animal from The Fort! This adoption application
was designed to help you as well as The Fort make the best possible choices. We want to
have the best possible homes for the pets in our care and we also want to assist you in
choosing the right pet for your family, lifestyle and activity level.
Please answer the following questions completely and honestly. As a reminder, all adoption
applicants must be over 21 years of age.
*
Indicates required field
Name
*
First
Last
Fort Rescue interested in adopting:
*
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Home Number
*
Work Number
*
Cell Number
*
Email
*
Are you currently:
*
Working
Attending School
Retired
Homemaker
Place of Employment
*
Do you:
*
Own your home
rent
live with parents/partner
Is your home:
*
House
Townhouse
Apartment
Condominium
Manufactured House
Duplex
How long have you lived at your current address?
*
Do you plan on moving in the next 12 months?
*
Yes
No
If you are planning to move, will the pet be able to accompany you?
*
Yes
No
If you own your home, please skip and go to next section
If you rent your home, are pets allowed to reside with you?
*
yes
no
If pets are allowed, are there any breed, size, weight or other special requirements such as declawing, additional insurance or deposits required? (if yes please explain)
*
What is your landlord's name?
*
Landlord's Phone Number
*
Do you understand we verify information with your landlord? Please inital
*
Please pick up here if you own your home.
Are there any children living in your household?
*
yes
no
Do other children (Friends or relatives) visit your home?
*
yes
no
If your answer to the previous questions was “yes”, please tell us the age and gender of the children that will have regular contact with your pet. (Note: We recommend that all children who will reside with this animal be present at the time of adoption)
*
Are there other family members or other persons who reside with you in your home?
*
yes
no
To the best of your knowledge, does anyone who resides in your home suffer from allergies to animals?
*
yes
no
Who will be financially responsible for the care, feeding, grooming and veterinary expenses associated with owning this pet?
*
Personal References
Please list two personal references who are not related to you that have known you for at least one year.
First Reference Name
*
First
Last
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Phone Number
*
Second Reference Name
*
First
Last
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Phone Number
*
Emergency contact information
Please list one emergency contact reference (to be used for microchip registration information).
Name
*
First
Last
Phone Number
*
Pet Information
What is your experience with the breed and/or species of pet you are applying to adopt from The Fort?
*
No experience
Have Owned One or More
Knowledgeable and Experienced
Do you currently own any other pets that will reside with the one you wish to adopt? (if no please skip to the next section)
*
yes
no
Please list all the pets you currently own
Species
*
Age
*
Sex
*
Spayed/Neutered?
*
yes
no
Kept:
*
Indoors
Outdoors
Both
How long have you owned this animal?
*
Is this animal current on all required vaccinations?
*
yes
no
Species
*
Age
*
Sex
*
Spayed/Neutered?
*
yes
no
Kept:
*
Indoors
Outdoors
Both
How long have you owned this animal?
*
Is this animal current on all required vaccinations?
*
yes
no
Species
*
Age
*
Sex
*
Spayed/Neutered?
*
yes
no
Kept:
*
Indoors
Outdoors
Both
How long have you owned this animal?
*
Is this animal current on all required vaccinations?
*
yes
no
What kinds of pets/animals have you owned in the past five (5) years?
Species
*
Age
*
Sex
*
Spayed/Neutered?
*
yes
no
Kept:
*
Indoors
Outdoors
Both
How long did you own this animal?
*
Species
*
Age
*
Sex
*
Spayed/Neutered?
*
Yes
No
Kept:
*
Indoors
Outdoors
Both
How long did you own this animal?
*
Species
*
Age
*
Sex
*
Spayed/Neutered?
*
yes
no
Kept:
*
Indoors
Outdoors
Both
How long did you own this animal?
*
Have you lost any animals within the past five (5) years? If yes, please describe the circumstances
*
Have any pets owned by you died within the past three (3) years? If yes, please describe the circumstances
*
If any of the animals you currently own are not spayed or neutered, would you please explain why you have not had this procedure done?
*
Who is your current veterinarian?
*
If you do not currently have a veterinarian, which veterinarian do you plan to consult for the care of this animal?
*
Are you aware of all applicable laws regarding pet ownership in the state, county, city or town relating to licensing, leash laws, vaccinations as well as duties and liabilities of pet ownership?
*
yes
no
Have you, anyone who resides with you in your home or anyone who will have contact with this animal ever been arrested, charged or convicted of any animal-related crime including but not limited to, abandonment, cruelty, neglect, animal-fighting, being a spectator at an animal fight and/or failure to have your pet vaccinated as required by law to the best of your knowledge?
*
yes
no
If yes, please explain the circumstances:
*
Hopes & Expectations
Reason for wanting a pet
*
What personality traits are you looking for in your companion animal?
*
Where will the animal live during the day? (i.e., indoors, both indoors and outdoors, at work, outdoors)
*
Where will the animal live at night? (i.e., indoors, both indoors and outdoors, at work, outdoors) If other please explain:
*
Describe pet’s expected play area:
*
Describe pet’s expected sleeping area:
*
Length of time animal will be left alone: (i.e., without people)
*
I am at home all day
1-4 hours
5-8 hours
8-12 hours
When the animal is outdoors, will he/she be in a fenced-in yard? If so, describe the type of fence, height of fence and condition of fencing
*
Describe outdoors shelter for the animal
*
If yard is not fenced, describe the area in which the animal will be kept
*
Time you expect to spend exercising your pet daily?
*
If this pet is a cat, will he/she be allowed outdoors?
*
yes
no
If yes, under what circumstances?
*
Adoption Follow-Up
As part of our commitment to having each adoption be a success, we will be keeping in touch with you. Please indicate the most appropriate time and phone number to reach you.
Time
*
Phone Number
*
Will you allow a volunteer of The Fort to inspect your property if necessary?
*
yes
no
If no, please tell us why you will not allow this?
*
Please Read and Sign
I hereby release to The Fort all veterinary records of the newly adopted animal if requested.
Name of Veterinary Hospital
*
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Phone Number
*
I certify that all the information in this application is true and I understand that false information may void the application. I also understand that failure to comply with future requirements, such as spaying or neutering, could result in my inability to adopt other animals from The Fort.
Signature
*
Date
*
Signature
*
Date
*
Submit
