AWS ADOPTION FORM

AWS ADOPTION FORM
ANIMAL WELFARE SOCIETY

8 DODD ROAD - NEW MILFORD CT 06776

Tel. 860.354.1350

aws-shelter.org
DATE*

MonthDayYear
Date
A. CONTACT INFORMATION
YOUR FULL NAME*

First NameLast Name
YOUR EMAIL ADDRESS*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
ADDRESS*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
B. ADOPTION INFORMATION
DOGPUPPYCATKITTEN
MaleFemaleNo Preference
SmallMediumLargeX-LargeNo Preference
BabyYoungAdult/MatureNo 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?
YesNo
YesNo
Pet 1

Complete only if you answered "Yes" above
Pet name
DogCat
Breed/Species
Age
MaleFemale
YesNo
YesNo
Pet 2
Pet name
DogCat
Breed/Species
Age
YesNo
YesNo
MaleFemale
Pet 3
Pet name
DogCat
Breed/Species
Age
YesNo
YesNo
MaleFemale
Pet 4
Pet name
DogCat
Breed/Species
Age
YesNo
YesNo
MaleFemale
Pet 5
Pet name
DogCat
Breed/Species
Age
YesNo
YesNo
MaleFemale
3a. Who is your current veterinarian?*
3c. Veterinarian Phone number*
If not applicable, enter 000-0000Format: (000) 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
HouseApartmentMobile HomeDuplexCondo
OwnRentLive with parentsLive with roommatesOther (Explain below)
If "Other" explain
YesNoUnsure
YesNo
4. If you rent:
LANDLORD'S NAME
Landlord contact
LANDLORD'S TELEPHONE NUMER
5. How long have you lived at your current address?*
YesNo
If "Yes" – what will you do with your pet?
YesNo
YesNo
7b. Fence height
7c. Type of fencing
8. How do you plan to exercise your dog?
12345+
YesNo
YesNo
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?
1-4 hours5-8 hours9-12 hours12+
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?
YesNo
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