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.


Are you? EmployedHomemakerStudentRetiredDisabled

Where do you live? HouseApartmentCondoMobile HomeDormOther
Do you? OwnRentLive with ParentsOther

How long have you lived at this address? Less than 2years2-5 years5+ years
Are you familiar with the pet responsibility laws in your area? YesNo
Are you willing to have a PAWS representative come to see where the dog will be living? YesNo
Please list all the members in your household:

Does any member of your household have allergies? YesNo
Would this be your first dog? YesNo
Do you have a fenced yard? YesNo
If yes, type of fencing:
Have you ever applied for an adoption or adopted a pet from PAWS? YesNo
Why are you interested in adopting this dog? Companion for another petGiftTo breedCompanionship
Are you familiar with the needs of a dog? YesNo
Have you ever taken an animal to a shelter? YesNo
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? YesNo
About your other/past pets
1. Pet’s Name
1. Type/Breed of animal
1. In or Out
1. Others
1. Age
1. Fixed?
1. GenderMaleFemale
1. Still own? YesNo
2. Pet’s Name
2. Type/Breed of animal
2. In or Out
2. Others
2. Age
2. Fixed?
2. GenderMaleFemale
2. Still own? YesNo
3. Pet’s Name
3. Type/Breed of animal
3. In or Out
3. Others
3. Age
3. Fixed?
3. GenderMaleFemale
3. Still own? YesNo
If you no longer have the pet(s) above, explain why:
Are all your pets up to date on shots and tags? YesNo
Who will care for your pet(s) if you travel?
ABOUT YOUR NEW PET
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? YesNo
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? YesNo
If no, why?
How did you hear about PAWS Humane Society? (Check all that apply) TVRadioPet StorePetfinder.comFriendPAWSHS.orgFacebookPAWS NewsletterOther
If newspaper, state the name:
If friend, state the name:
If petstore, state the name:
References:
Veterinarian
Veterinarian Phone::
Do we have your permission to contact? YesNo
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