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FOBAC Dog/Cat Adoption Form
Personal Information
E-Mail:*Valid e-mail is required
First Name:*
Last Name:*
Spouse/Partner/Housemate Name:
Address Line 1:*
City:*
State:*
Zip Code:*
Occupation
How long have you lived at your current address?*
Marital Status:
Gender:
Date of Birth:
Primary Phone # :*
Secondary Phone #:
How many children live in the home:*
Ages:
How many adults live in the home :*
Do you:*
Own your property
Rent your property
Live with your parents
If renting, please provide landlord`s name and telephone number:
Adoption Related Information
Which pet are you interested in?*
Color or breed preference (if any)*
What kind of pet do you want to adopt?*Choose multiple w/ Crtl key
Do you have a fenced in yard?*
Yes No 
Do you currently own a pet?*
Yes No 
Please list all companion animals you currently have:include type of pet & age
Name and phone number of Veterinarian (REQUIRED)
Where will this pet spend most of it`s time?*
How many hours a day will your new pet be without human companionship?*
Have you ever had to give up or find another home for a pet in the past?*
Yes No 
If yes, please explain?
Agree to home visit after 6 months:*
Yes No 

ADOPTION POLICY: ALL PETS WILL BE SPAYED OR NEUTERED BY DATE AGREED UPON AT TIME OF ADOPTION.

Contact information:

Friends of Berlin Animal Control
PO Box 1
Kensington, CT 06037
ph.860-828-5287
fobac.pets@yahoo.com

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