Wednesday, June 19, 2013
Site Map
Login
Adoptable Dogs
|
Adoptable Cats
|
Adoption Application
|
Donate
|
Contact Us
View Pets
Adoptable Dogs
Adoptable Cats
Adopted Dogs
Adopted Cats
Events
Calendar
Adoption Events
Adopting
Adoption Policies
Adoption Application
Fostering
Fostering Info
Foster Application
Animals Needing a Foster
Surrendering
Surrendering Policies
Surrender Application
Help Us
Donate
Volunteer
Online Store
Shop for a Cause
About Us
History
Blog
Memorials
Mission
Happy Tails
FAQ
Contact Us
Thank Yous
Links
Other Useful Links
In the News
Low Cost Clinics
Check our Reviews on
Angie's List
Application for Adoption
First Name:
Last Name:
Address:
City:
State:
Alabama
Alaska
Arizona
Armed Forces America
Armed Forces Europe
Armed Forces Pacific
Arkansas
California
Colorado
Connecticut
Delaware
District Of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip Code:
Primary Phone #:
We will attempt to contact you on this number first.
Secondary Phone #:
We will call this number if we can't contact you first on your Primary Phone Number.
Email:
1)
Are you at least 21 years of age?
Yes
No
2)
Do you own your residence?
Yes (I own)
No (I rent)
Please provide landlord name:
and phone number:
3)
Is this pet a gift?
Yes
No
4)
Are you a service or veteran member of the U.S. military and have your current military ID or DD214/proof of honorable discharge?
Yes
No
5)
How long have you lived at your current residence?
Years
Months
6)
Will you be moving in the near future?
Yes
No
7)
Will you assume full financial responsibility for your pet?
Yes
No
8)
Will you take your pet to the veterinarian within 30 days of adoption and regularly thereafter?
Yes
No
9)
Do you object to our visiting your home or calling you in the future?
Yes
No
10)
Why do you want a pet?
11)
How many pets have you had in the last 10 years?
Dogs
Cats
Other
12)
If not still with you, what has happened to them?
13)
Do you presently own any pets?
Dogs
Cats
Other
14)
Are your pets spayed/neutered?
Yes
No
Not Applicable
15)
Are all your pets current on their vaccinations?
Yes
No
Not Applicable
16)
Who is your Veterinarian and phone?
17)
Do you have a pet reference (someone who knows how you treat pets)?
18)
Are your pets inside or outside?
Inside
Outside
Not Applicable
19)
What is your occupation?
20)
How many hours will your pet be left alone daily?
0
0.5
1
1.5
2
2.5
3
3.5
4
4.5
5
5.5
6
6.5
7
7.5
8
8.5
9
9.5
10
10.5
11
11.5
12
21)
Where will your pet stay when you are not at home (i.e., the store)?
22)
Where will your new pet sleep?
23)
Who will care for your pet if you are on vacation?
24)
Does anyone in your home have an allergy to animals?
Yes
No
25)
List all people in home (name, relationship, age if child):
26)
Have the children been around pets?
Yes
No
Not Applicable
27)
What will you do if your new pet claws or chews your furniture or show signs of other destructive behavior?
28)
What animal behavior would you be unwilling to work with?
29)
Are you looking to adopt a dog or cat?
Dog
Cat
29a)
Do you have a fenced yard?
Yes
No
What type of fence? (under/above ground, height, material, etc)
29b)
Are you willing and able to leash walk your dog?
Yes
No
29c)
Will this be an inside or outside dog?
Inside
Outside
29d)
Will you keep a collar with ID tags on your pet at all times?
Yes
No
29a)
Will you have this cat declawed?
Yes
No
29b)
Are you wiling to keep it indoors at all times?
Yes
No
30)
Name of animal you are interested in: (if you wish to be a foster, simply enter FOSTER in this box)
31)
How did you hear about us?
-- Select --
Adopted from Paws and Prayers before
Adoption Event
AdoptAPet.com
Co-Worker
Facebook
Family Member
Friend
Internet Search
My Vet
Newsletter
PetFinder.com
Other (please specify)
I CERTIFY THAT THE ABOVE INFORMATION IS TRUE AND THAT ANY FALSE INFORMATION MAY RESULT IN THE NULLIFICATION OF THIS ADOPTION.
© 2010 Paws and Prayers - PO Box 2864 Akron, OH 44309 - (330) 475-8300