Name                                                                                                                          Date                                       

 

Address                                                                       City                                         State                ZIP                 

 

Home Phone                                      Work Phone                                       Other Phone                                      

 

Driver’s License                                                          E-Mail                                                                                    

 

1.   What type of pet are you interested in adopting?                                                                                                    

 

2.   Why do you want to adopt this pet?                                                                                                                  

 

3.   How long have you been thinking about getting a pet?                                                                                         

 

4.   What qualities are you looking for in a pet?                                                                                                      

 

5.   List all of your current pets and pets that you’ve had in the past ten (10) years:

 

Type of Pet		Spayed or Neutered?		Indoor? Outdoor? Both?		Living? Deceased?		If living, current on vaccines?		If deceased, list cause of death

 

6.   List the name and phone number of your veterinarian                                                                                         

      May we contact him or her for a reference?           Yes           No

 

7.   Do you own or rent your home?      Own       Rent

If you rent, does the owner permit the type, number and size of pets you will have?    Yes     No

If you rent, have you or will you pay any and all applicable pet deposits?    Yes       No

 

8.   Time Away From Home:     Someone home all day       Out part-time       Away 7-10 hours daily

 

 

9.   List all the members of your household, their age and whether they agree with getting this pet?

 

                                                                                                                                                                                   

 

                                                                                                                                                                                   

 

10a.     If you are adopting a cat, do you plan to declaw it?           Yes        No        Depends

            If so, would you consider a laser declaw?            Yes        No

 

10b.  If you are adopting a dog, is there a fenced yard?     Yes     No     Approximate size                            

 

11.  What type of lifestyle do you want your pet to live?                                                                                         

            Will the pet be kept inside, outside or both?      Inside       Outside       Both

            Will the pet be the only pet?      Yes       No  Explain                                                                            

            Where will the pet stay while you are not home?                                                                                       

            Where will the pet sleep?                                                                                                                              

            What rules will you establish for the pet?                                                                                                    

            What form of discipline will you use on the pet?                                                                                        

 

12. Have you ever adopted an animal from a rescue group or humane society?       Yes       No

      If so, when and which one?                                                                                                                               

 

13. Check any of the following reasons you would give your pet away:

              Fleas                                    Too expensive                                  Getting married/divorced

 

              Sheds too much                  Damages house                               Allergies

 

              New baby/pet                     New home doesn’t allow pets         Children won’t take care of it

 

              No longer plays                   Other                                

 

14. List the name and phone number of two additional pet references:

                                                                                                                                                                  

                                                                                                                                                              

 

15. How did you find out about Paw Prints Animal Rescue?                                                                                       

 

16. Would you have any objections if a Paw Prints Animal Rescue volunteer made a follow-up call or visit after the adoption?         Yes       No

 

Name of the pet(s) you would like to adopt:                                                                                                                       

 

  Approved                 Denied   By                                                                                                                                Date