Dog Adoption Form

Notice: To be considered for an adoption you must:
  • Be at least 21 years old.
  • Have the knowledge and consent of all adults living with you.
  • If renting have written consent from your landlord to have a dog at the address listed.
  • Consent to a home visit.
  • Understand that PAWS Humane Society has the right to deny your application for any reason.
Name of Dog you are interested in adopting:*
First Name:*
Last Name:
Are you?
Employer's Name
Work Phone:
You live in a:
Do you:
If you rent, Landlord's Name
Landlord's Phone
How long have you lived with this address?
If less than 2 years, please provide previous address:
Are you familiar with the pet responsibility laws in your area?
Are you willing to have a PAWS representative come to see where the dog will be living?
Please list all the members in your household:
1. Name
1. Relationship
1. Age
1. Their role in caring for your new pet?
2. Name
2. Relationship
2. Age
2. Their role in caring for your new pet?
3. Name
3. Relationship
3. Age
3. Their role in caring for your new pet?
Does any member of your household have allergies?
Would this be your first dog?
Do you have a fenced yard?
If yes, type of fencing?
Have you ever applied for an adoption or adopted a pet from PAWS?
Why are you interested in adopting this dog?
Are you familiar with the needs of a dog?
Have you ever taken an animal to a shelter?
If yes, for what reason?
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?
1. Pet Name
1. Type of animal
1. Pet's Age
1. Gender
1. Fixed
1. In/Out
1. Others
1. Still Own?
2. Pet Name
2. Type of animal
2. Pet's Age
2. Gender
2. Fixed
2. In/Out
2. Others
2. Still Own?
3. Pet Name
3. Type of animal
3. Pet's Age
3. Gender
3. Fixed
3. In/Out
3. Others
3. Still Own?
If you no longer own the above pet(s), please explain why:
Are all your pets up to date on shots and tags?
Who will care for your pet(s) if you travel?
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?
Where will the dog be kept during the day?
Where will the dog be kept during the night?
How many hours a day will your pet be without human companionship?
Please tell us why you would like to adopt this animal:
Please describe the most important characteristics and personality traits of your ideal pet.
If for some reason you can no longer keep this pet, do you understand that you must return it to PAWS?
If no, why?
How did you hear about PAWS Humane Society?
If Newspaper, state the name:
If Friend, state the name:
If Pet Store, state the name:
Veterinarian Phone:
Do we have your permission to contact?
Please list 2 personal references:
1. Name of Reference
1. Phone of Reference
1. Relationship to Reference
1. How long have you known this person?
2. Name of Reference
2. Phone of Reference
2. Relationship to Reference
2. How long have you known this person?
By submitting this application, I certify that the above information is accurate and truthful. I understand that any misrepresentation of the above information can result in the withdrawal of my application for adoption. I understand that all adoptions done by PAWS are at the discretion of authorized representatives of the agency and completion of this form does not guarantee adoption.