AWS ADOPTION FORM

AWS ADOPTION FORM
ANIMAL WELFARE SOCIETY

8 DODD ROAD - NEW MILFORD CT 06776

Tel. 860.354.1350

aws-shelter.org
DATE *

Month Day Year
Date
A. CONTACT INFORMATION
YOUR FULL NAME *

First Name Last Name
YOUR EMAIL ADDRESS *
example@example.com
Phone Number *
Please enter a valid phone number.
ADDRESS *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
B. ADOPTION INFORMATION
Indicate preference regarding the pet you are looking for *

DOG PUPPY CAT KITTEN
Gender *

Male Female No Preference
Size *

Small Medium Large X-Large No Preference
Age *

Baby Young Adult/Mature No Preference
Why are you looking to adopt a dog/cat? *
Breed/type of pet you are looking for:
If you are interested in specific breed(s), type(s) of a pet (long-haired, short-haired, certain colors, etc.) – please tell us as much as you can.
C. EXPERIENCE/HISTORY WITH PETS
If you are interested in adopting a cat, what would you do with a cat that was scratching your furniture or carpet?
If you are interested in adopting a dog, what kind of activity level would you be looking for in a dog?
If you are interested in adopting a dog, what kind of training would you plan to give your dog? Would you consider using the services of a professional trainer?
1. Is this your first experience with a pet? *

Yes No
2. Do you own any pets at the present time? *

Yes No
Pet 1

Complete only if you answered "Yes" above
Pet name
1. Type of pet

Dog Cat
Breed/Species
Age
Male or Female

Male Female
Spayed/Neutered

Yes No
Declawed

Yes No
Pet 2
Pet name
2. Type of pet

Dog Cat
Breed/Species
Age
Spayed/Neutered

Yes No
Declawed

Yes No
Male or Female

Male Female
Pet 3
Pet name
3. Type of pet

Dog Cat
Breed/Species
Age
Spayed/Neutered

Yes No
Declawed

Yes No
Male or Female

Male Female
Pet 4
Pet name
3. Type of pet

Dog Cat
Breed/Species
Age
Spayed/Neutered

Yes No
Declawed

Yes No
Male or Female

Male Female
Pet 5
Pet name
3. Type of pet

Dog Cat
Breed/Species
Age
Spayed/Neutered

Yes No
Declawed

Yes No
Male or Female

Male Female
3a. Who is your current veterinarian? *
3c. Veterinarian Phone number *
If not applicable, enter 000-0000
3b. What name would the records be under?
4a. How many dogs have you owned in the last 5 years?
4a. How many cats have you owned in the last 5 years?
5. What happened to those pets?
Be specific. Include, names, species, breed, ages, altered and veterinarian used.
D. HOME AND BOARDING
1. Do you currently live in a: *

House Apartment Mobile Home Duplex Condo
2. Do you currently: *

Own Rent Live with parents Live with roommates Other (Explain below)
If "Other" explain
3. If renting, does your lease allow for pets?

Yes No Unsure
3a.Will you be able to provide written consent?

Yes No
4. If you rent:
LANDLORD'S NAME
Landlord contact
LANDLORD'S TELEPHONE NUMER
5. How long have you lived at your current address? *
6. Do you have any plans of moving in the near future?

Yes No
If "Yes" – what will you do with your pet?
7. Do you have a private yard? *

Yes No
7a. If so, is the yard fenced in? *

Yes No
7b. Fence height
7c. Type of fencing
8. How do you plan to exercise your dog?
9. How many people live in household? *

1 2 3 4 5+
9a. Does anyone have allergies? *

Yes No
10. Do all adults know you plan to adopt? *

Yes No
11. If there are children in the household, what are their ages? *
EXAMPLE: 3, 12
12. If there are children visit your household, what are their ages?
13. In a typical day, how many hours will the animal be home alone? *

1-4 hours 5-8 hours 9-12 hours 12+
13. In a typical day, how many hours will the animal be home alone? *
13a. What arrangements have been made for when the animal is home alone?
14. Where will your pet be kept during the day? *
14a. Where will your pet be kept in the evening? *
15. Why would you return an animal to the shelter?
16. Are you willing and able to accept full and immediate responsibility for the ownership of a pet, including all health cost and necessary obligations for this animal? *

Yes No
By submitting this application, I hereby affirm that I have answered the above questions completely and honestly. I give Animal Welfare Society permission to obtain veterinary records and to follow up on references cited in this applicaition.
AWS OFFICE USE

AWS Representative:

Additional Notes and Comments:

AWS ADOPTION FORM, 07252021
Should be Empty:

AWS ADOPTION FORM

A. CONTACT INFORMATION

B. ADOPTION INFORMATION

C. EXPERIENCE/HISTORY WITH PETS

Pet 1

Pet 2

Pet 3

Pet 4

Pet 5

D. HOME AND BOARDING