Adoption Application Adoption Application 1YOUR INFORMATION, HOME AND PETS2YOUR NEW FURKID YOUR INFORMATIONFirst & Last Name* First Last First & Last Name of Second Adopter First Last Address* Street Address City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Mobile Phone – First Adopter*Mobile Phone – Second AdopterHome Phone*Email Address – First Adopter* Email Address – Second Adopter Age – First Adopter*Age – Second Adopter(If married include spouse or partner; must be 21+)Names and ages of all people living in your home, and their relationship to you.*(If you have children frequently visiting your home, please include their ages.)What is the name of the company where you (and your spouse, roommate or partner) are currently employed?*(If you are self-employed or do not work, please indicate that as well.)How many hours a day are you away from home?*(Please indicate both adopters’ work hours/day. If working from home, please explain.)Important Note Most of our dogs are in foster care in Southern California. Applicants located outside this area must be willing to come to Southern California to meet and adopt our dogs. When we have dogs in Northern California or Arizona, they are listed as such in our Available Dogs page. In addition, all of our volunteers give unselfishly of their time. Since your adoption process will involve several of us, please let us know if you are working with another rescue group. We are happy to work with adoption candidates – and give priority to those who are not working with other rescue groups.Are you willing to come to Southern California to meet a dog?* Yes No Are you working with another rescue group or groups?* Yes No If so, please list name of group or groups:How did you hear about Bichon Furkids Rescue?*When will you be ready to adopt and bring a Furkid into your home?*YOUR HOMEType of dwelling you live in:* House Condo Apartment Do you own or rent the home/condo you currently live in?* Own Rent If you rent, does your landlord approve your having a dog?* Yes No Do you have a fully fenced yard?* Yes No Please explain how you will handle toilet duties and exercise:*Do you have a pool?* Yes No If so, is the pool fenced? Yes No YOUR PETSDo you currently own a pet?* Yes No Describe your pets.For each pet, provide the name, breed, age, and weight.Is/are your pet(s) spayed or neutered?* Yes No If you don’t currently have a dog, have you owned one in the past?* Yes No If yes, please tell us what happened to this dog. If it died, how old was it and what was the cause of its death?Vet's Name:Vet's Address Street Address City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Please provide the names and phone numbers for two personal references (outside of family members).* Which FurKid are you interested in, and what are you looking for in the dog you adopt?*(Energy level, activities planned (E.G. good in the car, able to walk 3 miles, able to travel by plane), hypoallergenic, personality traits. Let us know if there is a particular dog you’re interested in, and why? (Please recognize that until you are approved to speak with placement, we cannot discuss a specific Furkid. Please also activity level of our Furkids and their needs. Please recognize that when you review bios on our website.)If the dog you are interested in is not available, are you open to meeting others we recommend?* Yes No Ideally, if we have a fit, what gender dog do you prefer?*Please note: fewer females are born and fewer are rescued. Male Female Doesn’t Matter What age and weight of dog would you ideally like to adopt?*Does everyone in your family want this dog?* Yes No Who will be responsible for this dog?*On Average, how many hours a day will the dog be left alone?*Please note: If you are more than 4 hours a day (2 hours for a puppy) and do not have a canine companion at home, we are not likely to have a Furkid we can place with you.WHERE DO YOU PLAN TO KEEP YOUR DOG WHILE YOU ARE GONE FOR SHORT PERIODS OF TIME (1-4 HRS)? FOR LONGER PERIODS OF TIME (OVERNIGHT OR MORE)?*Where in the house will the dog sleep?*Are you willing to accept the responsibility of housebreaking a dog if it is not already completely housebroken?* Yes No Are you prepared to ensure that this dog receives regular veterinary care?* Yes No Bichons and Bichon mixes require grooming for hair, ear, eye and nail care. Are you willing to provide these services?* Yes No Bichons often live for 15 years or more. Will you be able to provide care for this dog for its lifetime?* Yes No Note:In the event that you are unexpected incapacitated or that the Bichon could outlive you, who have you designated to care for the dog? This is a critically important issue to us – as we want each Furkid to be adopted to his or her forever family.Future Caregiver Information:*“Who do you designate to care for your dog should you become incapacitated or unable to continue care for your dog for any reason? “Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Email* Age:*(Must be 21+)Why do you want a rescued pet and how are you prepared to meet its needs?*Would you consider adopting a dog with special needs?* Yes No if yes, please check the special needs you feel you can handle. Mature Blind Deaf Allergies Ongoing Medical Care Terms and Conditions*I am at least twenty-one (21) years old and wanting to adopt a dog. I understand, that this Bichon Frise or Bichon mix, must be an indoor pet. This dog will be an inside dog and not be left unattended outside. I further understand, if for any reason that this adoption does not work out, I will return the dog to Bichon Furkids (BFK). I understand the tax deductible adoption fees are $750 for puppies under one year, $500 for a dog over a year old, and that senior dogs (over 10 years) may have a lower adoption fee. I further understand that once I have adopted a Furkid I will be notified of all BFK activities and events. (You may opt out at any time.) Yes No CAPTCHAPhoneThis field is for validation purposes and should be left unchanged.