Sunday, September 05, 2010
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Sunday, September 05, 2010 |
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copy and paste into microsoft word and/or email to Info@Pawshs.org PAWS Humane Society Dog Adoption Application Notice To be considered for an adoption today, you must:
So that we may be assured the dog you wish to adopt will be best suited to you, your home, and lifestyle, and be placed in an environment most compatible with its needs, please provide us with the following information by completing this form.
___________________________________________________________________________________________________________________________ Name of animal you are interested in adopting:_______________________________________________________ First Name: ____________________________________
Last Name: ___________________________________
Home Phone: ( ) _______________ Cell Phone: ( ) _________________
Address: __________________________________
City: ______________________ State: _______ Zip: ________
Are you: ___ Employed ___ A Homemaker ___
A Student ___ Retired ___ Disabled
Employer’s Name: _______________________________
Work Phone: ( ) _______________
Landlord’s Name: ________________________________
Landlord’s Phone: ( ) ____________
1. You live in a: ___ House ___ Apartment ___Condo
___Mobile home ___Dorm ___other
2. You: ___Own ___Rent ___Live with parents ___other
3. How long have you lived at this address: ___*less than two years ___2-5 years ___5+ years
*If less than 2 years, please provide previous address: ___________________________
4. Number of adults in this household? _____ How many children? _____ Ages? __________
5. Does any member of your household have allergies? ____Yes ___No
6. Would this be your first dog? ____Yes ____No
7. Are you familiar with the pet responsibility laws in your area? _______________________
8. Have you ever applied for an adoption or adopted a pet from PAWS? ___Yes ___No
9. Have you ever taken an animal to a shelter? ___*Yes ___No
* For what reason? ____________________________________________________ 10. Have you had a pet euthanized? ____*Yes ____No
*Explain____________________________________________________________ 11. Why are you interested in adopting this dog? (check all that apply)
___ Companion for another pet ___Gift ___To Breed ___Companionship 12. Are you familiar with the needs of a dog? ___Yes ___No
13. Dogs often live longer than 15 years, and you can expect to spend
several hundred dollars a year to feed, vaccinate, license,
and provide medical care for just one dog.
Are you ready to be responsible for this dog for its entire life? ___Yes ___No
14. Your new pet may take a month or longer to adjust to its new home, especially if you own other pets.
Are you willing to allow for this adjustment? _____Yes _____No 15. Where will the dog be kept during the day? _________________________________________
16. Where will the dog be kept during the night? ________________________________________
17. Do you have a completely fenced yard? ____*Yes ____No
*If yes…how high is the fence______________ 18. How many hours a day will the dog be without human companionship?________
19. If you travel frequently, who will care for your pet(s)? ___________________________________
20. How many cats and dogs currently live at this address? _____Cats _____Dogs
21. If you have other dogs, have they been obedience trained? ____Yes ____No
22. If you have other pets will they adjust to a new pet entering the household? __________________
23. Please list any pet(s) currently living at this address or previous pets within the last five years.
24. If you no longer own the above pet(s), please explain why: __________________________________
25. What is the name of your veterinarian or veterinary clinic? __________________________________
26. Does your pet(s) have a current rabies vaccination and county tags? _____Yes _____No
27. Do you believe in spaying and neutering? ___Yes ___No If no, why? ______________________
28. Are you willing to have a PAWS representative come to see where the dog will be living? __________
29. If for some reason you can no longer keep this pet, do you understand that you must return it to PAWS?
___Yes ___No Explain: ______________________________________________ 30. How did you hear about PAWS Humane Society?
_____Television _____Radio _____Newspaper _____Pet Store Please specify: ______________ _____Petfinder.com _____Pets911.com _____Pawshs.org _____Friend ______PAWS Newsletter EMAIL:____________________________________________________________<!--[endif]--><!--[endif]--> |
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