Step 1 of 333%About You and Your HomeName of Bunny You Would Like to AdoptName of Accompanying Bunny Partner You Would Like to AdoptList reasons for interest in adopting a bunny:Any Questions or Concerns About These Bunnies?Name* First Last Address* Street Address Address Line 2 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 Email* Phone*Your AgeYour Occupation*Type of Home*House, Apartment, Condo or Other. Please explainDo You Live Alone* Yes NoHow Many Adults are Living in the HomeAre All Adults Currently Living in This Home in Agreement on Bringing a New Bunny into the Home* Yes NoSpouse / Roommate AgeSpouse / Roommate OccupationAre any Children Living in the Home* Yes NoAllergies or Health Problems Related to PetsIf anyone in your home does have a pet related allergy or illness, please explain.Do Children Frequently Visit Your Home* Yes NoAbout Your PetsDo You Currently Have any Pets* Yes NoCurrent Pets in HouseholdType, age and genderAre Your Pets Current on Vaccinations and Heart Worm Prevention?* Yes NoDo Your Current Pets Get Along with Other Animals?* Yes No I don't knowCan You Provide a Permanent Home for the Duration of These Bunnies' Life* Yes NoHave you ever given any of your animals away for any reason?* Yes NoIf yes please explain:*Which of the Following Circumstances Would You Justify Giving Up a Bunny* Moving Divorce New Baby Escaping Fence Behavioral Problems Shedding Loss of Interest Time Consumption Allergies Housebreaking Size of Dog Medical Problems Aggression Unwanted Chewing Not Getting Along with Other Pets OtherOther, Please ExplainAdoptingIf This Bunny is Placed in Your Home and Subsequently the Adoption is Finalized, do You Agree That if You Must Later Surrender this Cat, You Will Only Surrender to a Representative of Furrytail Bunny Rescue.* Yes NoDate*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920
