{
    "fields": [
        {
            "index": 10,
            "lookups": "",
            "mandatory": true,
            "name": "reserveanimalname",
            "tooltip": "",
            "label": "Animal you are interested in adopting",
            "type": "ADOPTABLEANIMAL"
        },
        {
            "index": 30,
            "lookups": "",
            "mandatory": true,
            "name": "firstname",
            "tooltip": "",
            "label": "Applicant's First Name",
            "type": "TEXT"
        },
        {
            "index": 40,
            "lookups": "",
            "mandatory": true,
            "name": "lastname",
            "tooltip": "",
            "label": "Applicant's Last Name",
            "type": "TEXT"
        },
        {
            "index": 50,
            "lookups": "",
            "mandatory": true,
            "name": "address",
            "tooltip": "",
            "label": "Street Address",
            "type": "TEXT"
        },
        {
            "index": 60,
            "lookups": "",
            "mandatory": true,
            "name": "city",
            "tooltip": "",
            "label": "City",
            "type": "TEXT"
        },
        {
            "index": 70,
            "lookups": "",
            "mandatory": true,
            "name": "state",
            "tooltip": "",
            "label": "State",
            "type": "TEXT"
        },
        {
            "index": 80,
            "lookups": "",
            "mandatory": true,
            "name": "Apartment#",
            "tooltip": "",
            "label": "Apartment Number (if applicable)",
            "type": "TEXT"
        },
        {
            "index": 90,
            "lookups": "",
            "mandatory": true,
            "name": "zipcode",
            "tooltip": "",
            "label": "Zip Code",
            "type": "TEXT"
        },
        {
            "index": 100,
            "lookups": "",
            "mandatory": true,
            "name": "hometelephone",
            "tooltip": "Please use the following format 248-555-1212",
            "label": "Phone Number",
            "type": "TEXT"
        },
        {
            "index": 110,
            "lookups": "",
            "mandatory": true,
            "name": "emailaddress",
            "tooltip": "Please enter correctly as this is the main way we will contact you",
            "label": "Email Address",
            "type": "TEXT"
        },
        {
            "index": 120,
            "lookups": "",
            "mandatory": false,
            "name": "celltelephone",
            "tooltip": "",
            "label": "Alternate Phone Number",
            "type": "TEXT"
        },
        {
            "index": 130,
            "lookups": "",
            "mandatory": false,
            "name": "dateofbirth",
            "tooltip": "",
            "label": "Date of Birth",
            "type": "DATE"
        },
        {
            "index": 140,
            "lookups": "",
            "mandatory": false,
            "name": "Driverslicensenumber",
            "tooltip": "",
            "label": "Drivers License Number",
            "type": "TEXT"
        },
        {
            "index": 150,
            "lookups": "Petfinder|Internet Search|Family/Friend|Staff/Volunteer|Facebook/Twitter|Other",
            "mandatory": false,
            "name": "Howdidyoufindus",
            "tooltip": "",
            "label": "How did you find out about us?",
            "type": "LOOKUP"
        },
        {
            "index": 160,
            "lookups": "Yes",
            "mandatory": false,
            "name": "Haveyouappliedanywhereelse",
            "tooltip": "",
            "label": "Have you applied anywhere else for a pet?",
            "type": "YESNO"
        },
        {
            "index": 170,
            "lookups": "",
            "mandatory": false,
            "name": "Ifyeswhere",
            "tooltip": "",
            "label": "If yes, where else have you applied for a pet?",
            "type": "TEXT"
        },
        {
            "index": 180,
            "lookups": "Myself|Someone else",
            "mandatory": false,
            "name": "petownership",
            "tooltip": "",
            "label": "Is this pet for you or someone else?",
            "type": "LOOKUP"
        },
        {
            "index": 190,
            "lookups": "",
            "mandatory": false,
            "name": "otherpets",
            "tooltip": "",
            "label": "Do you own other pets at the current time?",
            "type": "YESNO"
        },
        {
            "index": 200,
            "lookups": "",
            "mandatory": false,
            "name": "ifyeswhatpets",
            "tooltip": "",
            "label": "If yes, please list their names, breeds, and ages.",
            "type": "NOTES"
        },
        {
            "index": 210,
            "lookups": "Yes|No|N/A",
            "mandatory": false,
            "name": "spayedneutered",
            "tooltip": "",
            "label": "Are all of your pets spayed/neutered/fixed?",
            "type": "LOOKUP"
        },
        {
            "index": 220,
            "lookups": "",
            "mandatory": false,
            "name": "Howmanypets",
            "tooltip": "",
            "label": "How many pets have you owned in the last 5-10 years?",
            "type": "TEXT"
        },
        {
            "index": 230,
            "lookups": "",
            "mandatory": false,
            "name": "whathappenedtothem",
            "tooltip": "",
            "label": "What happened to them?",
            "type": "NOTES"
        },
        {
            "index": 240,
            "lookups": "Yes|no|n/a",
            "mandatory": false,
            "name": "vacinations",
            "tooltip": "",
            "label": "Are your pets current on their vaccinations?",
            "type": "LOOKUP"
        },
        {
            "index": 250,
            "lookups": "",
            "mandatory": false,
            "name": "pettoshelter",
            "tooltip": "",
            "label": "Have you ever turned your dog or cat into a shelter?",
            "type": "YESNO"
        },
        {
            "index": 260,
            "lookups": "",
            "mandatory": false,
            "name": "ifyespleaseexplain",
            "tooltip": "",
            "label": "If yes, please explain?",
            "type": "NOTES"
        },
        {
            "index": 270,
            "lookups": "",
            "mandatory": false,
            "name": "veterinariansname",
            "tooltip": "If you have never owned a pet please tell us where you would go.",
            "label": "Veterinarian's Name",
            "type": "TEXT"
        },
        {
            "index": 280,
            "lookups": "",
            "mandatory": false,
            "name": "vetsaddress",
            "tooltip": "Again if you have never owned a pet please list where you would go",
            "label": "Veterinarian's Address, City, State, and Zip Code",
            "type": "NOTES"
        },
        {
            "index": 290,
            "lookups": "",
            "mandatory": false,
            "name": "vetphonenumber",
            "tooltip": "",
            "label": "Veterinarian's Phone Number",
            "type": "TEXT"
        },
        {
            "index": 300,
            "lookups": "",
            "mandatory": false,
            "name": "euthinized",
            "tooltip": "",
            "label": "Have you ever had a pet euthanized?",
            "type": "YESNO"
        },
        {
            "index": 310,
            "lookups": "",
            "mandatory": false,
            "name": "euthizereason",
            "tooltip": "",
            "label": "If yes, please explain:",
            "type": "NOTES"
        },
        {
            "index": 320,
            "lookups": "Agree|Disagree|Not Sure",
            "mandatory": false,
            "name": "spayedorneutered",
            "tooltip": "",
            "label": "How do you feel about having pets spayed/neutered?",
            "type": "LOOKUP"
        },
        {
            "index": 330,
            "lookups": "",
            "mandatory": false,
            "name": "heartworm",
            "tooltip": "",
            "label": "Are you familiar with heartworm and heartworm prevention?",
            "type": "YESNO"
        },
        {
            "index": 340,
            "lookups": "Yes|No|Unsure|N/A",
            "mandatory": false,
            "name": "petadjsutment",
            "tooltip": "",
            "label": "If you have pets, will they adjust to a new pet in the house?",
            "type": "LOOKUP"
        },
        {
            "index": 350,
            "lookups": "Yes|No|N/A",
            "mandatory": false,
            "name": "obedienceschool",
            "tooltip": "",
            "label": "Were any of your pets obedience trained?",
            "type": "LOOKUP"
        },
        {
            "index": 360,
            "lookups": "Companion| Family Pet| Child's Pet Guard Dog| Companion for another pet| Other",
            "mandatory": false,
            "name": "adoptionreason",
            "tooltip": "",
            "label": "Please check the main reason you plan to adopt a pet:",
            "type": "LOOKUP"
        },
        {
            "index": 370,
            "lookups": "",
            "mandatory": false,
            "name": "otherreasontoadopt",
            "tooltip": "",
            "label": "If you answered \"other\" above, please explain here:",
            "type": "NOTES"
        },
        {
            "index": 380,
            "lookups": "",
            "mandatory": false,
            "name": "describepetofinterest",
            "tooltip": "",
            "label": "Please describe in detail the pet you are looking for.",
            "type": "NOTES"
        },
        {
            "index": 390,
            "lookups": "Own|Rent|Someone else owns the Home|Someone else rents the Home",
            "mandatory": false,
            "name": "homeownership",
            "tooltip": "",
            "label": "Do you own or rent your home?",
            "type": "LOOKUP"
        },
        {
            "index": 400,
            "lookups": "House|Apartment|Condo|Townhouse|Mobile Home|Other",
            "mandatory": false,
            "name": "residenttype",
            "tooltip": "",
            "label": "Please select your current residence type.",
            "type": "LOOKUP"
        },
        {
            "index": 410,
            "lookups": "",
            "mandatory": false,
            "name": "otherhometype",
            "tooltip": "",
            "label": "If you answered \"other\" above, please explain here:",
            "type": "NOTES"
        },
        {
            "index": 420,
            "lookups": "Less than one month| 1-2 months|3-6 months| 6-9 months| 9-12 months|1-2 years|3-5 years|6-10 years|10 + years",
            "mandatory": false,
            "name": "Hometimein",
            "tooltip": "",
            "label": "How long have you lived at this address?",
            "type": "LOOKUP"
        },
        {
            "index": 430,
            "lookups": "Yes|No|Unsure|N/A",
            "mandatory": false,
            "name": "landlordallowspets",
            "tooltip": "",
            "label": "If you rent, does your landlord and lease allow pets?",
            "type": "LOOKUP"
        },
        {
            "index": 440,
            "lookups": "",
            "mandatory": false,
            "name": "numberinhouse",
            "tooltip": "",
            "label": "Including yourself, how many people live in your household?",
            "type": "TEXT"
        },
        {
            "index": 450,
            "lookups": "",
            "mandatory": false,
            "name": "agesinhouse",
            "tooltip": "",
            "label": "Please list the ages & relationship of those who live in your home.",
            "type": "NOTES"
        },
        {
            "index": 460,
            "lookups": "Yes| No| N/A",
            "mandatory": false,
            "name": "everybodyexpectspet",
            "tooltip": "",
            "label": "Is everyone in your household aware that you are planning to adopt a pet?",
            "type": "LOOKUP"
        },
        {
            "index": 470,
            "lookups": "Yes| No| Possibly| N/A",
            "mandatory": false,
            "name": "alergies",
            "tooltip": "",
            "label": "Does anyone in your household have allergies to dogs/cats?",
            "type": "LOOKUP"
        },
        {
            "index": 480,
            "lookups": "Full-Time| Part-Time| Retired| Work from Home|Stay at Home Parent| Student| Unemployed| Other",
            "mandatory": false,
            "name": "employment",
            "tooltip": "",
            "label": "Employment Status",
            "type": "LOOKUP"
        },
        {
            "index": 490,
            "lookups": "",
            "mandatory": false,
            "name": "employmentother",
            "tooltip": "",
            "label": "If you chose \"other\" above, please explain:",
            "type": "NOTES"
        },
        {
            "index": 500,
            "lookups": "",
            "mandatory": false,
            "name": "currentoccupation",
            "tooltip": "",
            "label": "If you are employed, what is your current occupation?",
            "type": "TEXT"
        },
        {
            "index": 510,
            "lookups": "",
            "mandatory": false,
            "name": "petleftalone",
            "tooltip": "",
            "label": "On average, how many hours per day will your pet be left alone?",
            "type": "TEXT"
        },
        {
            "index": 520,
            "lookups": "About $100| $100 - $200| $200 - $300| $300 - $500| $500 +",
            "mandatory": false,
            "name": "estvetbills",
            "tooltip": "",
            "label": "How much do you think the annual medical bills will be for your pet?",
            "type": "LOOKUP"
        },
        {
            "index": 530,
            "lookups": "",
            "mandatory": false,
            "name": "billoverage",
            "tooltip": "",
            "label": "What would you do if the bills went over this amount?",
            "type": "NOTES"
        },
        {
            "index": 540,
            "lookups": "Inside|Outside| Both",
            "mandatory": false,
            "name": "insideoutside",
            "tooltip": "",
            "label": "Will this pet be predominantly living inside, outside, or both?",
            "type": "LOOKUP"
        },
        {
            "index": 550,
            "lookups": "",
            "mandatory": false,
            "name": "livingconditiions",
            "tooltip": "",
            "label": "Please provide a description of this pet's living conditions.",
            "type": "NOTES"
        },
        {
            "index": 560,
            "lookups": "Wood| Chain Link| Electric| Plastic|Iron|Other|Other (I do not have a fenced yard)",
            "mandatory": false,
            "name": "fencedyard",
            "tooltip": "",
            "label": "Do you have a completely fenced-in yard? If so, what kind of fence?",
            "type": "LOOKUP"
        },
        {
            "index": 570,
            "lookups": "",
            "mandatory": false,
            "name": "otheronfencing",
            "tooltip": "",
            "label": "If you answered \"other\" above, please explain:",
            "type": "NOTES"
        },
        {
            "index": 580,
            "lookups": "",
            "mandatory": false,
            "name": "dogletout",
            "tooltip": "",
            "label": "If you do not have a fenced yard, how will you let the animal out?",
            "type": "NOTES"
        },
        {
            "index": 590,
            "lookups": "Yes|No|N/A",
            "mandatory": false,
            "name": "chainedup",
            "tooltip": "",
            "label": "Are there times when the animal will be tied/chained up?",
            "type": "LOOKUP"
        },
        {
            "index": 600,
            "lookups": "",
            "mandatory": false,
            "name": "chainedwhen",
            "tooltip": "",
            "label": "If yes, when will they be tied/chained up?",
            "type": "NOTES"
        },
        {
            "index": 610,
            "lookups": "In bed with me| In bed with my child| In a dog / cat bed| In a kennel / crate| Wherever he or she likes| Outside| Other",
            "mandatory": false,
            "name": "wheresleep",
            "tooltip": "",
            "label": "Where will the animal sleep?",
            "type": "LOOKUP"
        },
        {
            "index": 620,
            "lookups": "",
            "mandatory": false,
            "name": "otherwheresleep",
            "tooltip": "",
            "label": "If you answered \"other\" above, please explain:",
            "type": "NOTES"
        },
        {
            "index": 630,
            "lookups": "Yes|No|N/A",
            "mandatory": false,
            "name": "garagetime",
            "tooltip": "",
            "label": "Will the animal spend any time in the garage?",
            "type": "LOOKUP"
        },
        {
            "index": 640,
            "lookups": "",
            "mandatory": false,
            "name": "explaingarage",
            "tooltip": "",
            "label": "If the animal will spend time in the garage, please explain when/why:",
            "type": "NOTES"
        },
        {
            "index": 650,
            "lookups": "",
            "mandatory": false,
            "name": "Pool",
            "tooltip": "",
            "label": "Do you have a pool?",
            "type": "YESNO"
        },
        {
            "index": 660,
            "lookups": "N/A|Yes|No",
            "mandatory": false,
            "name": "Poolfence",
            "tooltip": "",
            "label": "Is there a fence around the pool?",
            "type": "LOOKUP"
        },
        {
            "index": 670,
            "lookups": "N/A| Wood| Chain Link| Plastic| Iron| Other",
            "mandatory": false,
            "name": "poolfencetype",
            "tooltip": "",
            "label": "What kind of fence do you have around your pool?",
            "type": "LOOKUP"
        },
        {
            "index": 680,
            "lookups": "",
            "mandatory": false,
            "name": "otherfence",
            "tooltip": "",
            "label": "If you answered \"other\" above, please explain:",
            "type": "NOTES"
        },
        {
            "index": 690,
            "lookups": "",
            "mandatory": false,
            "name": "housebreaking",
            "tooltip": "",
            "label": "How will you handle housebreaking?",
            "type": "NOTES"
        },
        {
            "index": 700,
            "lookups": "",
            "mandatory": false,
            "name": "destructivebehavior",
            "tooltip": "",
            "label": "How will you handle destructive behavior?",
            "type": "NOTES"
        },
        {
            "index": 710,
            "lookups": "",
            "mandatory": false,
            "name": "updatevaccinations",
            "tooltip": "",
            "label": "Will you keep the animal up-to-date on vaccinations and heartworm preventative?",
            "type": "YESNO"
        },
        {
            "index": 720,
            "lookups": "",
            "mandatory": false,
            "name": "explainnovaccinations",
            "tooltip": "",
            "label": "If no, please explain:",
            "type": "NOTES"
        },
        {
            "index": 730,
            "lookups": "Yes|No|N/A",
            "mandatory": false,
            "name": "willintoexercise",
            "tooltip": "",
            "label": "Are you willing and able to exercise the dog on a regular basis?",
            "type": "LOOKUP"
        },
        {
            "index": 740,
            "lookups": "Walking| Running| Dog Park / Dog Run| Other",
            "mandatory": false,
            "name": "exercisetype",
            "tooltip": "",
            "label": "If yes, what is the method of exercise?",
            "type": "LOOKUP"
        },
        {
            "index": 750,
            "lookups": "",
            "mandatory": false,
            "name": "otherexercise",
            "tooltip": "",
            "label": "If you answered \"other\" above, please explain:",
            "type": "NOTES"
        },
        {
            "index": 760,
            "lookups": "",
            "mandatory": false,
            "name": "abuse",
            "tooltip": "",
            "label": "Have you ever been convicted of abuse or neglect of a child or animal?",
            "type": "YESNO"
        },
        {
            "index": 770,
            "lookups": "",
            "mandatory": false,
            "name": "abuseexplanation",
            "tooltip": "",
            "label": "If yes, please explain:",
            "type": "NOTES"
        },
        {
            "index": 780,
            "lookups": "Yes|No|N/A",
            "mandatory": false,
            "name": "pickuptruck",
            "tooltip": "",
            "label": "If you drive a pick up truck, would you allow the animal to ride in the back/bed?",
            "type": "LOOKUP"
        },
        {
            "index": 790,
            "lookups": "Leave with family/friend|Boarding|Pet Sitter|Take with me/us| Other",
            "mandatory": false,
            "name": "emergencyarragements",
            "tooltip": "",
            "label": "What arrangements will you make for the care of your pets in case of an emergency?",
            "type": "LOOKUP"
        },
        {
            "index": 800,
            "lookups": "",
            "mandatory": false,
            "name": "emergencyother",
            "tooltip": "",
            "label": "If you answered \"other\" above, please explain:",
            "type": "NOTES"
        },
        {
            "index": 810,
            "lookups": "Leave with family/friend| Boarding|Pet sitter|Take with me/us| Other",
            "mandatory": false,
            "name": "vacation",
            "tooltip": "",
            "label": "What will you do with the animal when you go on vacation?",
            "type": "LOOKUP"
        },
        {
            "index": 820,
            "lookups": "",
            "mandatory": false,
            "name": "vacationother",
            "tooltip": "",
            "label": "If you answered \"other\" above, please explain:",
            "type": "NOTES"
        },
        {
            "index": 830,
            "lookups": "",
            "mandatory": false,
            "name": "animalgiveup",
            "tooltip": "",
            "label": "For what reason(s) would you consider returning/giving up the animal?",
            "type": "NOTES"
        },
        {
            "index": 840,
            "lookups": "Take him / her with me|Give to family or friend| Return to shelter|Other",
            "mandatory": false,
            "name": "movingandanimal",
            "tooltip": "",
            "label": "What would you do with your animal if you had to move?",
            "type": "LOOKUP"
        },
        {
            "index": 850,
            "lookups": "",
            "mandatory": false,
            "name": "movingother",
            "tooltip": "",
            "label": "If you answered \"other\" above, please explain:",
            "type": "NOTES"
        },
        {
            "index": 860,
            "lookups": "",
            "mandatory": false,
            "name": "keepanimalforyears",
            "tooltip": "",
            "label": "Are you willing to take responsibility for this animal for the next 10-20 years?",
            "type": "YESNO"
        },
        {
            "index": 870,
            "lookups": "",
            "mandatory": false,
            "name": "notokeepinganimal",
            "tooltip": "",
            "label": "If no, please explain:",
            "type": "NOTES"
        },
        {
            "index": 880,
            "lookups": "",
            "mandatory": false,
            "name": "Homechecks",
            "tooltip": "",
            "label": "Will you allow us to perform home checks?",
            "type": "YESNO"
        },
        {
            "index": 890,
            "lookups": "Yes|No",
            "mandatory": false,
            "name": "contractagreement",
            "tooltip": "",
            "label": "I have read the foregoing and certify that the answers I have given are complete, true and not misleading in any way. I am authorizing you to contact landlords, associations and veterinarians. You are also aware that we cannot guarantee the health and temperament of the animal.",
            "type": "LOOKUP"
        }
    ],
    "name": "Adoption Application",
    "description": "",
    "header": "",
    "footer": ""
}
