PAWS & PRAYERS PET RESCUE

ADOPTION APPLICATION

Personal Information
  Name:   
  Address:   
  City   
  State:   
  Zip Code:   
  Home Phone:   
  Work Phone:   
  Email Address:   

Comments and Questions
  1) Are you at least 21 years of age?    Yes No
  2) Do you rent or own your residence?    Rent Own
  If you rent, can you verify you can have a pet?    Yes No
  3) Is this pet a gift?    Yes No
  4) How long have you been at your current
    residence?		   
  Will you be moving soon?    Yes No
  5) Will you assume full financial responsibility for
    your pet?		    Yes No
  6) Will you take your pet to the veterinarian within
    30 days of adoption and regularly thereafter?		    Yes No
  7) Do you object to our visiting your home or calling
    you in the future? 		   Yes No
  8) Why do you want a pet?
  9) How many pets have you had in the last 10 years?    Dogs Cats Other
  If not still with you, what has happened to them?
  10) Do you presently own any pets?    Dogs Cats Other
  11) Are your pets spayed/neutered?    Yes No
  12) Are all your pets current on their vaccinations?    Yes No
  13) Who is your Veterinarian and phone?
  14) Do you have a pet reference (someone who knows how you treat pets)?
  15) Are your pets inside or outside?    Inside Outside
  16) What is your occupation?   
  17) How many hours will your pet be left alone daily?   
  18) Where will your pet stay when you are not at home (i.e., the store)?
  19) Where will your new pet sleep?
  20) Who will care for your pet if you are on vacation?
  21) Does anyone in your home have an allergy to
    animals?		    Yes No
  If yes:    Dogs Cats Other
  22) List the ages of any children in your home:
  23) Have the children been around pets?    Yes No
  24) What will you do if your new pet claws or chews your furniture or show signs of other destructive
    behavior?
  25) What animal behavior would you be unwilling to work with?
  26) See below:
  For cat adoptions:
  If adopting a cat, will you have it declawed?    Yes No
  Are you wiling to keep it indoors at all times?    Yes No
  For dog adoptions:
  Do you have a fenced yard?    Yes No
  Are you willing and able to leash walk your dog?    Yes No
  Will this be an inside or outside dog?    Inside Outside
  If adopting a dog, will you keep a collar with ID tags
    on your pet at all times?		    Yes No
  
  Name of animal you are interested in:   
I CERTIFY THAT THE ABOVE INFORMATION IS TRUE AND THAT ANY FALSE INFORMATION MAY RESULT IN THE NULLIFICATION OF THIS ADOPTION.