FLASh
Friends of the Lafayette Animal Shelter

First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

Email*

Home Phone

Cell Phone*

Which pet are you interested in adopting?
Sorry, no animals found

Your Age*

Please list the names and ages of other people living in your home.*

How long have you lived there?*

How would you describe your home atmosphere most of the time?*
Choose one: Very busy, active Busy sometimes, quiet other times Quiet, not much activity

Type of home*
Choose one: Military Housing Own House Own Mobile Home Rent Apartment Rent House Rent Mobile Home

Please provide your landlord's full name and phone number, if renting.

Who is your veterinarian? Include past vet, if you've had pets in the past. (Full Name, City, and phone number)*

What is your level of experience with dogs?*
Choose one: First Time Owner Have had one or two Knowledgeable and experienced

Is your yard securely fenced? (Fenced all the way around)

What type of fence to you have? Chain link? Wooden/privacy? Other?

Where will your dog live?*
Choose one: Outside only Inside only Inside and Outside

How long are you away from home most days?*
Choose one: 1-3 hours 3-6 hours 6-10 hours Home almost all day

How will you exercise your dog, take them out to potty?*

Where will your dog stay when you are not at home?*
Choose one: inside outside both (have doggy door)

Tell us about the pets you have now. Dog? Cat? Name? How long have you had them?

Where does your dog(s) live?
Choose one: Inside only Outside only Both

Are all of your present pets spayed/neutered?
Choose one: Yes No

Please tell us about your past pets. Please include dogs and cats, how long you had them, and what happened to them.

Please feel free to share anything else you'd like us to know.