PPP

Please fill out this form, sign the e-signature with your mouse, and click submit when it is complete. Completing this application is a step in the process of acquiring a dog from Prison Paws Partnership ~ Humane Society of Del Norte, but it does not guarantee you will get a dog without further review. Our adoptions are not on a first-come first-served basis. Dogs will be matched to adopters through the application process to best suit the needs of both. Please keep in mind that (for now) there are only four dogs available from each round of training and we expect multiple applications for each dog. If you are accepted as an adopter, you will be required to sign an adoption contract.

One Application can be used for one or more dogs. Please be specific about which dog(s) you are interested in.

ADOPTION FEE: The PPP/HSDN adoption fee is $150 which includes the dog being spayed/neutered prior to adoption, current on shots, current on preventive treatment for fleas/ear mites/worms, a small bag of food, a free vet check-up (if adoption is local), Basic Obedience training and Canine Good Citizen training.

RENTAL AGREEMENT: If you rent your home, you may be required to supply a rental agreement proving that pets are allowed.

MEET AND GREET: We are checking with the prison to see if it's possible to set-up "meet and greets" somewhere on prison grounds. If you have other dogs, we request that you bring them along.

HOME CHECK: A home check will be required to make certain your home is an appropriate match for the dog you are interested in adopting.

FEEDBACK: Although not required, the inmates who lovingly trained your dog always like to know how they are doing in their forever home. A feedback letter thanking them and letting them know how your dog is doing in his/her new home would be greatly appreciated, with photos if possible. Inmates will not receive your address if you choose not to disclose.

Please choose the dog/dogs you are interested in adopting. *

Milo ~ PPP #005 (ADOPTED) Rascal ~ PPP #006 Mater ~ PPP #007 (ADOPTED) Jack ~ PPP #008 (ADOPTED)

Tell us why you chose this dog.... *

How did you hear about the Prison Paws Partnership? *

News Media Humane Society of Del Norte Website Facebook Friend or Family Member I am PBSP staff, or a friend/family member is PBSP staff I am a Family Member of a PPP Dog Handler

Your Name (First & Last): *

Street Address: *

City, State, Zip *

Phone Number: *

Area Code Phone Number

Cell Phone:

Area Code Phone Number

E-mail: *

How do you prefer to be contacted? *

Phone Text Email

Are you employed? *

Yes No

Employer Name *

Employer phone number: *

Please list two personal references with phone numbers. *

Do you consent to a brief home visit, prior to finalizing an adoption? *

Yes No

Type of housing *

House Apartment Mobile home

How long have you been at current address? *

Do you own or rent? *

Own Rent

If renting, please provide name and contact number for landlord/property management: *

We may require a copy of the "pet" portion of your rental agreement.

Does your landlord/property management allow dogs at your residence? *

Yes No

Are there any restrictions from your landlord/property management? *

Number of pets Size or weight restrictions Breed restrictions None

Size of your backyard: *

Small Average Large Extra Large Patio (No Yard)

Do you have a fully fenced yard? *

Yes No

Height & type of fence: (N/A if not applicable or no fence) *

How many adults are in your household? *

How many children are in your household? *

Please list children's ages:(N/A if no children) *

Have children in the home been around animals, before? *

Yes No N/A

Does anyone in your home have asthma or pet related allergies? *

Yes No

Who will be the pet's primary caregiver? *

Household Activity Level: *

Quiet Active Very Active

Are all members of your household in agreement with this adoption? *

Yes No I Don't Know

Do you currently have pets? *

Yes No

Please list all current pets: (Breed & Age included) (N/A if no pets) *

Are your pets up to date on vaccines & preventatives? If not, briefly explain why: (N/A if no pets) *

How many of these pets are spayed/neutered? (N/A if no pets) *

Have you adopted from a rescue group or shelter, previously? *

Yes No

If yes, which rescue/shelter? (N/A if no) *

Have you ever had to surrender an animal? *

Yes No

If yes, please briefly explain the circumstances? (N/A if no) *

Do you have a vet you use, currently? *

Yes No

If so, please provide the name, address, & phone number of your vet: (N/A if no) *

Your new dog will be mostly... *

Indoor Outdoor

How many hours each day will your new dog be home alone? *

Where will your dog stay when your are not home? *

Where will your new dog sleep at night? *

How do you plan on helping your new dog best adjust to their new home? *

What will you do if bad habits form? *

Are you willing to work with the dog if any behaviors of concern arise? *

Yes No

Under what circumstances would you have to give up your pet? *

Do you agree to contact us in the event that you need to re-home this dog for any reason? *

Yes No

Would you allow us to use your photos and/or testimonials to post on our social media and/or website? ***Your approval/disapproval will in no way influence your acceptance as a HSDN/PPP adopter.

Yes No

Please provide any other relevant information you think we need to know about placing a dog in your home.

I agree that the information I have provided is true.

I understand that applying does not guarantee adoption.

I understand that there may be multiple applications for each dog and if I am not chosen as an adopter for the dog I have applied for, I will be able to apply for a different dog in the future.

I understand that adoptions through HSDN/PPP are not first-come first-serve. Dogs are matched to adopters through the application process to best suit the needs of both.

I understand that the $150 adoption fee is to help cover some of the costs of vetting and caring for the PPP dogs and will help HSDN/PPP continue this amazing program.

Electronic Signature *

Clear

*

Date

Please allow HSDN 2-3 business days to process your application. You will be contacted through the info you provided. Thank You for considering an HSDN/PPP dog!

Prison Paws Partnership

Applicant Information:

Household Information:

Current/Previous Pet Information: