Adoptionn Application(New)

<!DOCTYPE html> <html lang="en"> <head> <meta charset="UTF-8"> <meta name="viewport" content="width=device-width, initial-scale=1.0"> <title>Dog Adoption Application</title> <style> body { font-family: Arial, sans-serif; background-color: #f8f9fa; margin: 0; padding: 20px; } .form-container { max-width: 800px; margin: auto; background: #fff; padding: 25px; border-radius: 8px; box-shadow: 0 4px 10px rgba(0,0,0,0.1); } h2 { text-align: center; color: #333; margin-bottom: 20px; } h3 { color: #444; border-bottom: 2px solid #eee; padding-bottom: 5px; margin-top: 25px; } label { font-weight: bold; display: block; margin-top: 15px; color: #333; } input[type="text"], input[type="email"], input[type="tel"], input[type="number"], select, textarea { width: 100%; padding: 10px; margin-top: 5px; border: 1px solid #ccc; border-radius: 4px; font-size: 14px; } textarea { resize: vertical; } input[type="checkbox"] { margin-right: 10px; } button { background-color: #007bff; color: #fff; padding: 12px 20px; border: none; border-radius: 4px; font-size: 16px; cursor: pointer; margin-top: 20px; width: 100%; } button:hover { background-color: #0056b3; } @media (max-width: 600px) { .form-container { padding: 15px; } h2 { font-size: 22px; } } </style> </head> <body> <div class="form-container"> <h2>Dog Adoption Application Form</h2> <form action="/submit-adoption-form" method="post"> <h3>Applicant Information</h3> <label>Full Name:</label> <input type="text" name="full_name" required> <label>Address:</label> <input type="text" name="address" required> <label>City, State, ZIP:</label> <input type="text" name="city_state_zip" required> <label>Phone Number:</label> <input type="tel" name="phone" required> <label>Email Address:</label> <input type="email" name="email" required> <label>What is the best time to reach you?</label> <input type="text" name="best_time"> <label>How did you hear about R&R Boxer Rescue?</label> <input type="text" name="referral"> <h3>Household Information</h3> <label>Do you rent or own your home?</label> <select name="rent_or_own"> <option value="rent">Rent</option> <option value="own">Own</option> </select> <label>If renting, landlord’s name and phone:</label> <input type="text" name="landlord"> <label>Type of residence:</label> <input type="text" name="residence_type"> <label>Do you have a fenced yard?</label> <select name="fenced_yard"> <option value="yes">Yes</option> <option value="no">No</option> </select> <label>If Yes, what is the highest and lowest point?</label> <input type="text" name="yard_height"> <label>Number of adults in household:</label> <input type="number" name="adults"> <label>Number of children and ages:</label> <input type="text" name="children"> <h3>Pet Experience</h3> <label>Have you owned dogs before?</label> <select name="owned_dogs"> <option value="yes">Yes</option> <option value="no">No</option> </select> <label>List pets in the past 10 years including what happened to them:</label> <textarea name="past_pets" rows="3"></textarea> <label>Current pets (species, age):</label> <textarea name="current_pets" rows="2"></textarea> <label>Are your pets spayed/neutered?</label> <select name="spayed_neutered"> <option value="yes">Yes</option> <option value="no">No</option> </select> <label>Veterinarian name and contact:</label> <input type="text" name="vet_contact"> <h3>Lifestyle & Care</h3> <label>How many hours per day will the dog be alone?</label> <input type="text" name="hours_alone"> <label>Where will the dog sleep?</label> <input type="text" name="sleep_location"> <label>Where will the pet be kept during the day?</label> <input type="text" name="day_location"> <label>How often will the dog be exercised?</label> <input type="text" name="exercise_frequency"> <label>Who will be responsible for the daily care of the dog?</label> <input type="text" name="daily_care"> <label>Who will care for the dog if you travel?</label> <input type="text" name="travel_care"> <label>Are you willing to do crate training, if necessary?</label> <select name="crate_training"> <option value="yes">Yes</option> <option value="no">No</option> </select> <label>How long of an adjustment period do you think should be given to a new pet?</label> <input type="text" name="adjustment_period"> <label>Do you agree to provide healthcare for your new pet?</label> <select name="healthcare_agreement"> <option value="yes">Yes</option> <option value="no">No</option> </select> <label>Will you allow R&R Boxer Rescue to visit your home (either in person or virtually) for a home check prior to adoption as well as post adoption?</label> <select name="home_check"> <option value="yes">Yes</option> <option value="no">No</option> </select> <h3>Preferences</h3> <label>Age preference:</label> <input type="text" name="age_preference"> <label>Are you willing to adopt a dog with special needs?</label> <select name="special_needs"> <option value="yes">Yes</option> <option value="no">No</option> </select> <label>Are there any specific dogs you are interested in from our website or social media sites?</label> <input type="text" name="specific_dogs"> <h3>Additional Information</h3> <label>Is there anything else you would like us to know?</label> <textarea name="additional_info" rows="3"></textarea> <h3>Agreement</h3> <input type="checkbox" name="agreement" required> I certify that the information provided is true and complete.<br><br> <button type="submit">Submit Application</button> </form> </div> </body> </html>