Adoption Application
Type(s) of animal you are interested in adopting
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Cat
Kitten
Dog
Puppy
Specific animal(s) you are interested in adopting
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Title
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Choose One
Mr.
Mrs.
Mr. and Mrs.
Ms.
Dr.
Applicant's First Name
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Applicant's Last Name
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Co-Applicant's (if any) First Name
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Co-Applicant's (if any) Last Name
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Street Address
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Apartment/Unit Number (if applicable)
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City
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State
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Zip Code
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Phone Number
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Alternate Phone Number
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Email Address
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Alternate Email Address
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Have you applied anywhere else for a pet?
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Choose One
Yes
No
If yes, where else have you applied for a pet?
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Have you ever adopted a pet from a rescue group or shelter?
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Choose One
Yes
No
If yes, which group or shelter?
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Is this pet for you or someone else?
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Choose One
Myself
Someone else
Do you own pets at the current time?
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Choose One
Yes
No
List first pet's name as it appears on its vet record.
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List first pet's species.
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Choose One
Cat
Dog
Other
Is first pet spayed/neutered?
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Choose One
Yes
No
Is first pet current on its vaccinations?
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Choose One
Yes
No
Where does first pet live?
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Choose One
Indoors
Outdoors
Both indoors and outdoors
List second pet's name as it appears on its vet record.
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List second pet's species.
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Choose One
Cat
Dog
Other
Is second pet spayed/neutered?
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Choose One
Yes
No
Is second pet current on its vaccines?
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Choose One
Yes
No
Where does second pet live?
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Choose One
Indoors
Outdoors
Both indoors and outdoors
How many pets have you owned in the last 5 years?
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What happened to them?
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Have you ever turned your dog or cat into a shelter?
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Choose One
Yes
No
If yes, please explain?
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Veterinarian's Name
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Veterinarian's Phone Number
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Do you own or rent your home?
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Choose One
Own
Rent
Please select your current residence type.
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Choose One
House
Apartment
Townhouse
Other
If you answered "other" above, please explain here.
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If you rent, does your landlord and lease allow pets?
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Choose One
Yes
No
Unsure
Including yourself, how many people live in your household?
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Please list the ages and relationship of those who live in your home.
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Is everyone in your household aware that you are planning to adopt a pet?
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Choose One
Yes
No
Does anyone in your household have allergies to dogs/cats?
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Yes Cats
Yes Dogs
No
Possibly
Please check the reasons you plan to adopt a pet.
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Companion
Family Pet
Companion for another pet
Exercise buddy
Other
If you answered "other" above, please explain here.
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On average, how many hours per day will your pet be left alone?
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How much do you think the annual cost of having this pet will be?
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Will this pet live indoors, outdoors, or both?
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Choose One
Indoors
Outdoors
Both
Where will the animal sleep?
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Choose One
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
If you answered "other" above, please explain.
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How will you handle introductions to other pets (if any)?
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How will you handle undesirable or destructive behavior?
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If you are adopting a cat or kitten, do you plan to declaw it?
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Choose One
Yes
No
Depends
If you are adopting a dog or puppy, do you have a fenced-in yard?
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Choose One
Yes
No
If you are adopting a dog or puppy and don't have a fenced yard, how will you let the animal out and provide exercise?
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If you are adopting a dog or puppy, are there times when the animal will be tied/chained up?
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Choose One
Yes
No
Pets can live many years. If your pet(s) were to survive you, what would happen to them?
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For what reason(s) would you consider returning/giving up the animal?
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Fleas
Sheds too much
New baby or new pet
Children won't care for it
Too expensive
Damages home
Getting married/divorced
No longer playful
New home doesn't allow
Allergies
No reason
Other
If you answered "other" above, please explain.
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Would you have any objections to a Paw Prints volunteer visiting your home prior to or after adoption?
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Choose One
Yes
No
Additional information you would like to provide?
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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.
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Choose One
Yes
No