The Zeus & Luna 2 Pay it Forward Foundation Puppy Application Form

Puppy Application, Contract and Waiver

Are you or have you ever been in the military, if so please select what Branch*

Are you or have you been in EMS, if so please select from the dropdown

In order to qualify for our program you must show proof of either military background (Active, Disabled and must have been honorably discharged) and or Emergency Services such as Police, Fire, EMT. You must show that you are currently employed and a acknowledge that a background check will be completed in order to verify that you have not had any sitations, arrests, or convictions for agravated assault on humans and or animals.

Perspective Pet Parent*

First NameLast Name

Name of Pet You Wish to Adopt*

Email Address*

Phone Number*

Area CodePhone Number

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Do you own any pets?*

Pet Name(s)

Pet Breed(s)

Pet's disposition and behavior towards other dogs?

Please provide your veterinarian's name and phone number:

Do you own or rent your home?*

OwnRent

Do you have a yard?*

YesNo

If "Yes" to the above, is it fenced? please describe

What is your landlord's pet policy?*

If you rent, please provide your landlord's information here:*

Have you ever surrendered a pet you own to any animal shelter including a "low" or "no kill" shelter?*

YesNo

Are there children in the home? (If yes, please list ages)*

If you answered "Yes" to the above question, please provide detail:

How many hours per day would the pet be alone?*

Will you crate your pet?*

If you have to leave town, emergently or planned, where would your pet stay?*

How would you deal with behavioral issues such as barking, chewing, destructive behavior, bathroom accidents indoors, unruly leash behaviors in your pet?*

Please provide the names, emails, and contact numbers for 3 personal references:*

Have you ever been convicted of an animal related crime, such as cruelty to animals, animal theft, or animal abandonment?*

YesNo

If you answered "Yes" please provide a detailed description:

By clicking the submit button, I agree to Zues & Luna 2 Pay it Forward Foundation's Puppy receival process, and will undergo a homecheck, and interview at the discretion of the Zues & Luna 2 Pay it Forward Foundation.
By clicking the submit button I will provide verification that I am a Veteran or currently in the service, I will provide verification (DD-214).
By clicking the submit button and am not a veteran, I will show verification of EMS service, Police, Fire, etc.
By clicking the submit button, I understand The Zeus & Luna 2 Pay it Forward Foundation will check my references including veterinary and personal.
By clicking the submit button, I understand there is no "cooling off" period, and that if I no longer want or can no longer care for my puppy, I agree to notify The Zeus & Luna 2 Pay it Forward Foundation BY EMAIL and provide a 14 day period to allow The Zeus & Luna 2 Pay it Forward Foundation to make arrangents for my puppy to be taken back.
By clicking the submit button, I agree to indemnify and hold harmless The Zeus & Luna 2 Pay it Forward Foundation against any losses, lawsuits, claims, injury, damages incurred by me or to any persons or property by my puppy, once the placement has been completed.
By clicking the submit button, I understand that The Zeus & Luna 2 Pay it Forward Foundation will disclose any of the pet's health or behavior issues known by the above before the placement is completed.
By clicking the submit button, I understand that if I no longer want my pet, or am no longer able to care for my puppy, I will be directed to surrender my puppy to The Zeus & Luna 2 Pay it Forward Foundation and provide transport to where The Zeus & Luna 2 Pay it Forward Foundation deems appropriate.
By clicking the submit button, I verify all of the above information is true and accurate.

Signature of Potential Pet Parent*