DOG/PUPPY ADOPTION APPLICATION

Date:
Animal Name: / #:
Breed: / Sex: / Age

Paws & Claws Animal Rescue, Inc

P.O. Box 223

Hebron, KY 41048

WELCOME TO THE PAWS & CLAWS ANIMAL RESCUE, INC

We are happy that you have come to us to adopt a canine friend. We hope that we can be of service to you. To help ensure that the animal you are expressing interest in will be best suited to you, your home and lifestyle, and that the animal will be placed in an environment compatible with its needs, we ask your cooperation in filling out the application. We hope you will agree that the animal’s welfare MUST be our foremost consideration. Upon completion of this application, an adoption volunteer will discuss the adoption with you and answer any questions you might have. We ask for your patience and cooperation. Thank you.
Please note that PAC does not adopt any animal to individuals under the age of 20.

Applicant Information

Applicant Name
Driver’s License #
Street Address
City, State and Zip Code
FULL Mailing Address (if different from above)
Home Phone Number
Work Phone Number
Alternate Phone
Email Address
Place of employment
Co-Applicant (if applicable)

Please list ALL adults and children in your household. Please include yourself.

Name / Age / Relationship
Self
Do all the adult members listed above know that you are planning to adopt a dog/puppy?
Are the children in your home used to animals? Explain.
Is anyone in your home allergic to animals?

Residence Information

Describe your residence / house apartment duplex mobile home other______
Do you… / own rent live with parent/guardian/other
If renting, does the landlord/rental agency allow pets?
Landlord name
Landlord phone number
How long have you lived at your current address?
Do you anticipate moving in the next 6 months?
If you move in the future, what will you do with your pets?
Do you have a fenced yard? If yes, please describe (height, type, etc)
Will this fence safely contain a dog?

If you have other pets, please provide the following information on your animals:

KIND / SEX / AGE / TIME OWNED / SPAYED/NEUTERED / STILL OWN?
Are your current dogs licensed?
Please list any other pets you have owned in the last five years. Please explain why you no longer own the animal.

Veterinary Information

Are all your pets current on their vaccinations?
If no, please explain
What is the name of your veterinary clinic?
Veterinarian Phone Number
How long have you been with this vet?
If less than one year, please list previous vet (if applicable)

Dog Ownership Questions

Why do you want to adopt a dog?
What types of activities are you looking to do with your dog?
How many hours a day will the dog be alone (without human companionship)
Where will the dog be during the day?
Where will the dog be at night?
Will this dog be allowed indoors?
Where will this dog sleep?
When the dog is outside, will it be… / In a fenced yard on a leash allowed to run loose on a trolley chained other: ______
What kind of outside shelter will be provided?
Are you willing to enroll this dog in obedience classes?
Are you aware of your local animal control regulations?
Will you license this dog?
The financial commitment and responsibilities of owning a dog can be approx. $400 a year for basic care. Are you willing to spend this much or more to care for the dog?
Adding a new dog is a big change; are you willing to give the dog adequate time to adjust to your household? (at least two weeks)
Do you have any experience in working with issues such as housetraining, resource guarding or anxiety? Please explain.
Would you allow a representative from Paws and Claws into your home prior to adoption?

REFERENCES

One reference must be a veterinarian. Other references may include neighbors or co-workers. Only ONE may be a family member

Name / Relationship / Phone number with area code

By signing below, I certify that the information I have given is true and that any misrepresentation of facts may result in my losing the privilege of adopting a companion animal from the Paws & Claws Animal Rescue, Inc. I agree to hold Paws and Claws Animal Rescue, Inc. harmless in the event that dog/puppy cause harm to me or any other living thing during any pre-adoption meetings. I also understand that the completion of this application indicates my interest in this dog/puppy and that it does not guarantee adoption. I understand that an adoption contract must be signed prior to my taking possession of the dog/puppy.

If you are approved and at any time during the course of your adoption you feel that the dog is not a good fit for your home, he/she must be returned to the care of PAC Animal Rescue.

Signature Date

Paws & Claws Animal Rescue, Inc reserves the right to refuse any applicant.

Paws & Claws Representative: ______

Representative Signature: ______

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