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91 Ready Ave N.W. Fort Walton Beach, FL 32548

911 Ruff Hours of Operation: 10am - 7pm, 7 Days-a-week

E-Forms Lost Dog Form Found Dog Form Turn-in Dog Form

ADOPTION APPLICATION FORM

Thank you for your interest in our dogs. We would appreciate your answers to the following question so we can best find the right canine for you. Submission of this application does not guarantee that you will receive a dog.

First Name:		Date:
Last Name:
Age:		E-Mail Address:
Address:
City:
State:		Zip Code:
Home Phone:		Cell Phone:
Are you married or have a significant other? YesNo SpouseSignificant Other
Spouse's Name:		Spouse's Age:
Are you self employed? YesNo
Employer:	Dept:	Phone:
Spouse's Employer:	Spouse's Dept:	Phone:
If military, what is your rank:
Number of Children:		Their Ages:
Is everyone in your household in agreement on adopting a canine?		YesNo
If no, who is not?		Why?
Besides your immediate family, are there others residing in your home?		YesNo
Names & Ages:
Do they have pets?		YesNo
Whose name is the lease / mortgage in?
How long have you lived at your current address?
If less than 2 years, please list your previous addresses including City and State for the last 10 years: