Adoption - Forget Me Not Animal Rescue

Pet Name*
How did you hear about us?
Name*
First Last
Age*
Please enter a number from 18 to 99.
Phone*
Email*

Home Address*
Street Address Address Line 2 City State ZIP Code
Do you rent or own?*
- Rent
- Own
How long have you lived at your current residence?*
Type of House*
Landlord's Name and Contact Info*
Are pets allowed where you're renting?*
- Yes
- No
My yard has...

Number of Adults in Household*
Marital Status*
Age(s) of Children Living in your Househould
Age of Child
Do Children Visit your Household?*
- Yes
- No
Age(s) of Children Visiting your Househould*
Age of Child
Who will be the Responsible Caregiver of the New Pet?*
Concerns You or Your Family have about Adopting a New Pet?

Do any Family Members have Allergies?*
- Yes
- No
Please describe your allergies?*
How long have you been considering adopting?*
Reason for adopting new pet?*
What/who is the pet for? (Select all that apply)*
- For a Child
- For a Family Member
- For Companionship
- For Security
- For Animal Companionship
- For a Gift
- For a Friend

You or your spouse's employer*
Employer Address
Street Address Address Line 2 City State ZIP Code
Employer Phone

How many hours will pet be without human companionship?*
Where will pet be kept at night?*
Where will pet be kept during the day when alone?*
Will pet be inside or outside majority of the time?*
What is the maximum amount of time pet will be outside unattended?*

List all your current pets
Type Name Age Breed
Are your pets spayed or neutered?
- Yes
- No
Are all of your pets current on vaccinations and preventatives?*
- Yes
- No
In order to adopt a dog from FMNR- current dogs must be kept on a heartworm prevention i.e heartgard, revolution, interceptor etc. Failure to provide info or proof will mean application may be denied. Rabies vaccine is required by law therefore unless valid medical reason, current cats/dogs not current on Rabies may have application denied.
What vaccinations or treatments will you keep your new pet on?*
List the vaccinations and treatments
What is your estimated yearly cost for the animal?*
What brand of food do you plan on feeding your pet?*
If adopting a cat from FMNR do you plan on declawing?*
What would you do if emergency or costs exceeded $1000?*

Vet Name*
Vet Address
Street Address Address Line 2 City State ZIP Code

***This field is required if you have current pets
Phone
***This field is required if you have current pets.

Please list all pets (as an adult) you have had in the past 5 years
Type Breed Where are they now?
If deceased, what were the causes?
Do you plan to enroll your new pet in training and why?
Would you have a problem with any of the following situations?
- Chewing
- Jumping
- Digging
- Scratching
- House training mistakes
- Running away
- Other mischievous behavior
How would you deal with these situations?*
What behaviors would cause you to return your pet?
Have you adopted another pet from a shelter?*
- Yes
- No
When did you adopt another pet?*
MM slash DD slash YYYY
Where did you adopt another pet?*
Have you ever brought an animal to a shelter or animal control facility?*
- Yes
- No
Please explain why you brought a pet to a shelter of animal control facility?*
Please provide the name and phone number of 3 personal references*
Name Phone

References must not all be family and failure to provide 3 references may result in dismissal of application.
Briefly describe how the pet would spend it's day?*
Please Read and Agree to Terms in order to submit application:*
- Yes
- No
Applicant agrees that any information above is truthful and correct. Applicant is aware FMNR reserves the right to decline application based on lack of response to questions and also due to misinformation or failure to provide correct information. FMNR also reserves the right to not disclose application denial due to confidentiality of references etc. Submitting application is not a guarantee to adopt a FMNR animal but is required to initiate adoption process. After submission of application an FMNR volunteer will contact you in 24/48 hours if you do not get a response please email us at [email protected].. if at any point in adoption process you are no longer interested in adoption through our agency please be respectful of our time and let us know or we may refuse adoption in the future. FMNR does not hold on to applications after a 3 month period so applicant will have to start a new application. If applicant understands information above and agrees please check yes.
Email
This field is for validation purposes and should be left unchanged.

Adoption Application

What's next?

Step 1 of 9

Forget Me Not

PO Box 483
Manhattan, IL 60442

(815) 935-9503

Look Around

Age of Child

Age of Child

Type	Name	Age	Breed

List the vaccinations and treatments

Adoption Application

What's next?

Step 1 of 9

Forget Me Not

PO Box 483Manhattan, IL 60442

(815) 935-9503

Look Around

Tail Us

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PO Box 483
Manhattan, IL 60442