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ARFLA Adoption Application
Welcome to ARFLA! Thank you for considering adoption of a rescued animal. The animal’s welfare is our foremost consideration, so this questionnaire is designed to help us determine if this adoption is in the animal’s best interest and to help you find an animal most compatible with your lifestyle.
***THIS APPLICATION MUST BE COMPLETED ON A COMPUTER. It cannot be completed on a pad nor cell phone. You will receive a confirmation email once your application is successfully submitted.***
Date Time
MM
/
DD
/
YYYY
Name
*
First
Last
Address
*
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Antigua and Barbuda
Aruba
Bahamas
Barbados
Belize
Canada
Cayman Islands
Cook Islands
Costa Rica
Cuba
Dominica
Dominican Republic
El Salvador
Grenada
Guatemala
Haiti
Honduras
Jamaica
Mexico
Netherlands Antilles
Nicaragua
Panama
Puerto Rico
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Trinidad and Tobago
United States
Argentina
Bolivia
Brazil
Chile
Colombia
Ecuador
Guyana
Paraguay
Peru
Suriname
Uruguay
Venezuela
Albania
Andorra
Armenia
Austria
Azerbaijan
Belarus
Belgium
Bosnia and Herzegovina
Bulgaria
Croatia
Cyprus
Czech Republic
Denmark
Estonia
Faroe Islands
Finland
France
Georgia
Germany
Greece
Hungary
Iceland
Ireland
Italy
Kosovo
Latvia
Liechtenstein
Lithuania
Luxembourg
Macedonia
Malta
Moldova
Monaco
Montenegro
Netherlands
Norway
Poland
Portugal
Romania
San Marino
Serbia
Slovakia
Slovenia
Spain
Sweden
Switzerland
Ukraine
United Kingdom
Vatican City
Afghanistan
Bahrain
Bangladesh
Bhutan
Brunei Darussalam
Myanmar
Cambodia
China
East Timor
Hong Kong
India
Indonesia
Iran
Iraq
Israel
Japan
Jordan
Kazakhstan
North Korea
South Korea
Kuwait
Kyrgyzstan
Laos
Lebanon
Malaysia
Maldives
Mongolia
Nepal
Oman
Pakistan
Palestine
Philippines
Qatar
Russia
Saudi Arabia
Singapore
Sri Lanka
Syria
Taiwan
Tajikistan
Thailand
Turkey
Turkmenistan
United Arab Emirates
Uzbekistan
Vietnam
Yemen
Australia
Fiji
Kiribati
Marshall Islands
Micronesia
Nauru
New Zealand
Palau
Papua New Guinea
Samoa
Solomon Islands
Tonga
Tuvalu
Vanuatu
Algeria
Angola
Benin
Botswana
Burkina Faso
Burundi
Cameroon
Cape Verde
Central African Republic
Chad
Comoros
Democratic Republic of the Congo
Republic of the Congo
Djibouti
Egypt
Equatorial Guinea
Eritrea
Ethiopia
Gabon
Gambia
Ghana
Gibraltar
Guinea
Guinea-Bissau
Cote d'Ivoire
Kenya
Lesotho
Liberia
Libya
Madagascar
Malawi
Mali
Mauritania
Mauritius
Morocco
Mozambique
Namibia
Niger
Nigeria
Rwanda
Sao Tome and Principe
Senegal
Seychelles
Sierra Leone
Somalia
South Africa
Sudan
Swaziland
United Republic of Tanzania
Togo
Tunisia
Uganda
Zambia
Zimbabwe
Country / Region
Phone
*
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Email
*
YOUR AGE
*
Would you like to receive ARF newsletters and updates?
*
Yes
No
Dogs Name Interested in Adopting
*
Is this your first experience with a pet?
*
Yes
No
List all pets you have owned in the past ten (10) years.
Pet 1: (Name, breed, age, length owned, fixed?, kept where? what happened to pet?
*
Pet 2: (Name, breed, age, lenght owned, fixed?, kept where? what happened to pet?
Pet 3: (Name, breed, age, lenght owned, fixed?, kept where? what happened to pet?
Pet 5: (Name, breed, age, lenght owned, fixed?, kept where? what happened to pet?
Pet 4: (Name, breed, age, lenght owned, fixed?, kept where? what happened to pet?
Who is your veterinarian? Veterinarian's phone number? Name account is listed under (ie: yourself, spouse, parent, etc).
*
Please list other veterinarians you have used in the past with phone number and name account is listed under (ie: spouse, parent, etc).
*
Do you live in a:
*
House
Apartment
Condo
Mobile Home
Does your lease allow pets? Is there a size limit?
Yes
Yes - Size Limit
No
What is your Landlords Name and phone number?
*
How long have you lived at this address?
*
Are there children in your household or who visit often? What are their ages?
*
Do you or anyone in your household have allergies to animals?
*
Yes
No
Who will be responsible for the care of this pet?
*
Where will the pet be kept during the day? At night?
*
How many hours a day will this pet spend alone?
*
Where will the pet be kept when alone?
*
Are you familiar with the use of a dog crate to train the pet during your absence or at night?
*
Yes
No
LOUISIANA LAW REQUIRES THAT ALL ANIMALS ADOPTED FROM AN RESCUE OR HUMANE SOCIETY BE SPAYED OR NEUTERED.
Do you agree to comply with this requirement?
*
Yes
No
May ARFLA make follow-up calls and /or visits?
*
Yes
No
Why do you want a dog: (Please check at least one)
*
House Pet
Companion
Protection
Company for Pet
Hunting Dog
Do you have a fully fenced in yard?
Yes
No
If yes, what kind? Height?
Do you have a doggy door?
*
Yes
No
Do you know how to house train a pet? (Even previously trained pets need a period of adjustment)
*
Yes
No
Would you like information on house training?
Yes
No
Are you familiar with the leash and licensing laws of your community and state?
*
Yes
No
What will you do if your dog chews on furniture, shoes, siding or shows other destructive behavior?
*
Are you familiar with heart worm disease?
*
Yes
No
What type of heart worm prevention medicine will you use?
*
How will you keep your dog confined to your property? (Check all that apply)
*
In House
Fenced Yard
Leash
Outdoor Patio
Outdoor Kennel
Chain
Runner/ Zip Line
How will you secure your dog when traveling in a vehicle?
*
Pet Taxi
Seatbelt Harness
Free in Rear
In Rear of SUV
In back of open Pickup Truck
Have you ever sold, given away, or surrendered a pet to a shelter, rescue or any person?
*
Yes
No
If, yes, please specify why?
Please tell us a little about your lifestyle and your family - including any special activities in which your dog would be included.
*
How will the dog be exercised?
*
If and when you move, what will you do with your pet?
*
Please tell us how you became aware of ARFLA?
*
Adoption Event
Facebook
Friend or Relative
ARFLA's website
Internet Search
Veterinarian
****ARF-LA, INC.RESERVES THE RIGHT TO REFUSE ADOPTION TO ANYONE ****
In order to be considered, you must:
be 21 years of age or older
have identification showing your present address
have the knowledge and consent of your landlord
be able and willing to spend the time and money necessary to provide training, medical treatment, support and care of a pet
have a fenced-in yard
All resident animals must be altered*, up-to-date on vaccinations, HW tested yearly and on HW preventative.
**Do you understand this?
*
Yes
No
Each of our pets is examined upon arrival and is provided with ordinary, or in some cases extraordinary veterinary care. They are routinely monitored while awaiting adoption, but there is always a chance that an animal is incubation a disease without showing any clinical signs.
Do you understand this? (Required)
*
Yes
No
Our adoption fee of $200.00 includes spay/neuter, if not already done; micro-chip, first vaccinations, for puppies or adults; routine worming, and any needed medicine the animal has received in our care. If you adopt a puppy, you MUST provide vaccinations until the pet is at least six months old! After that, yearly exams and vaccinations are required.
IN THE EVENT THAT AN ADOPTION DOES NOT WORK OUT, ARF requires the pet be RETURNED so that we may re-home it. HOWEVER, 72 HOURS AFTER RECEIVING THE PET, PLEASE CONSIDER YOUR ADOPTION FEE A TAX-DEDUCTIBLE DONATION TO ARF.
Do you understand this?
*
Yes
No
By typing your name here, you agree to the following: By submission of this application, I assert that all statements and answers given here are the truth. I give ARF-LA representatives permission to verify that the information is true and correct.
