Forte Animal Rescue Dog Adoption Questionnaire
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3PO Box 10085, Marina del Rey, CA 90295
phone/fax (310) 362-0321
DOG ADOPTION QUESTIONNAIRE
It is our policy to make certain that each person who adopts a dog is aware of the responsibilities of pet guardianship, and
is capable of and willing to accept those responsibilities morally, physically and financially. Not every person who desires to
adopt a dog should do so.
By completing this questionnaire, you will aid us in determining if you and your family are indeed ready for pet guardianship,
and if the dog of your interest would suit you and your lifestyle. Should you agree that adopting a pet is a commitment
throughout the lifetime of your companion animal, please fill out this questionnaire.
DOG(S) OF INTEREST:
_______________________________________________________________________
PERSONAL INFORMATION
Name: ___________________________________________ Age: ¨ Under 20 • ¨ 20-35 • ¨ 35-50 • ¨ 50+
Name of ¨ spouse • ¨ partner • ¨ roommate: ____________________________________________________
Street address: ____________________________________________________________________________
City: _____________________________________________________ State: _______
Zip: _____________
CA
Home phone: _____________________________
Work phone: ___________________________________
Cellular phone: ____________________________
email: _________________________________________
Occupation: __________________________________ Spouse’s occupation: __________________________
Work schedule: ________________________________ Spouse’s hours: ______________________________
Names of all persons living in your household, their relationship to you and their ages:
__________________________________________
__________________________________________
__________________________________________
__________________________________________
Please list two personal references and their relationship to you:
Name: ___________________________
Relationship: ________________
Phone: ____________________
Name: ___________________________
Relationship: ________________
Phone: ____________________
YOUR HOME
Type of dwelling? ¨ House • ¨ Apt • ¨ Condo • ¨ Other ___________________________________________
¨ Own or ¨ Rent?
If Condo, what are the association’s rules about pets? _____________________________
Your home has: ¨ 1 story • ¨ 2 stories
If you have yard: ¨ Fenced (height: _____ feet) • ¨ Unfenced
Does your home have a pool? ¨ Yes • ¨ No
If you have a pool, is it fenced? ______________________________________________________________
How do you introduce a dog to pool? ________________________________________________________
Would you allow an inspection of your home by a rescue volunteer? ¨ Yes • ¨ No
If not a homeowner, do you have the landlord’s permission to have a dog? _________________________________
Landlord’s name: _____________________________________
Phone: ______________________________
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