Adoption Application

Adoption Application
The information we request in this form is to ensure that we are finding a quality permanent home for our pets. This information assists us in achieving the best match between a pet and a potential new owner.
Name

First Name Last Name
Birth Date

Month Day Year
Date
Co-Applicant

First Name Last Name
Birth Date

Month Day Year
Date
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Home Phone:
Work Phone:
Cell Phone
Email
example@example.com
Place of Employment
Place of Employment
Best Time of Day to be Contacted
Primary Residence:

Own Rent/Lease
How long at this residence
If you rent/lease, are pets allowed?

Yes No
Is anyone home during the day?

Yes No
How many hours would dog/cat be alone?
Where will the dog/cat stay when home alone?
Have you/anyone in the household ever owned a dog/cat?

Yes No
Are there children in the household?

Yes No
Do all adults in the household agree on adopting this dog/cat?

Yes No
Are there children in the household?

Yes No
If Yes, ages of children
Do you have any neighbors, family, and/or friends who have children that will visit your home?

Yes: No
If yes, ages of children that will visit your home?
Is there anyone in your household with asthma or allergies to cats/dogs?

Yes No
Will you allow us to conduct a home visit prior to adoption?

Yes No
What do you do with your pets while on vacation?
Why are you interested in adopting this dog/cat?
Landlord Reference:

If you do not own your home, we will need to speak to your landlord to confirm you can have a cat/dog and discuss any pet restrictions on your lease; adults living in a home owned by their parents will need to list their parents as landlords. We highly recommend reviewing your lease and/or speaking to your landlord about your plans to adopt a cat/dog in advance; that way you will be aware of any restrictions and any fees that may be imposed in your lease.
What other pets do you currently have?
Type
Breed
Name
Age
Sex

Male Female
Spayed/Neutured?

Yes No
Type
Breed
Name
Age
Sex

Male Female
Spayed/Neutured?

Yes No
Type
Breed
Name
Age
Sex

Male Female
Spayed/Neutured?

Yes No
Where are these animals kept?
What other pets have you had in the past five years?
What happened to them? If any of your pets have passed away, please provide age and cause of death.
What kinds of problems, if any, did you have with them?
Have you ever surrendered a pet to or returned a dog/cat to a shelter?

Yes No
If yes, explain
Have you ever given away or sold a dog/cat?

Yes No
If yes, explain
Adopted pets need time to adjust to their new surroundings. Are you willing to give the new dog/cat at least a one month trial to allow the dog/cat adequate time to adjust?

Yes No
What would you consider a reason for not keeping an adopted pet?
If you currently have a dog/cat, what type of food do you use?

Wet Dry
How often do you feed the dog/cat?

1 x day 2 x day Self Feeder
Do you use heartworm prevention with your pets?

Yes No
What kind of heart worm medics do you use?
Do you use flea prevention with your pets?

Yes No
What kind flea prevention do you use?
Veterinarian Name:
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
May we contact your veterinarian?

Yes No
If no current Veterinarian, name and number of another Veterinarian used in the past.

If no Veterinarian reference, on a separate sheet of paper please provide the name and number of 2 personal references other than a relative. These may include neighbors, coworkers, breeders, trainers, etc.
FOR DOG ADOPTIONS ONLY
Do you own or have you ever used a crate?

Yes, own and have used No, but have used one Do not own and have not used one
Is your fence attached to your house?

Yes No
Is there shade in the yard?

Yes No
Is there shelter in the yard?

Yes No
Do you have a dog door into your house or garage?

Yes No
Will the dog ever be left outside unattended?

Yes No
If yes, for how long?
If no fence, how will the dog be let outside?
Are you looking for a dog as a:

Companion Watchdog Playmate for another dog Playmate for a child Gift for another person Other
By submitting this application, I agree that:

1. If I am approved for adoption and I cannot keep the adopted dog for any reason, it will be returned to Paved Paws Animal League immediately.

2. I am authorizing, through submission of this form, the Veterinarian(s) named above to release any information and records concerning past or present care of animals to Paved Paws Animal League. I agree to hold harmless and indemnify said Veterinarian(s) for providing such information.

3. I have not, nor has anyone in my household ever been charged with any form of animal abuse, neglect, or cruelty.
4. I am 18 years of age and I have read this application in its entirety and have answered each question honestly and to the best of my ability.

Agree Disagree Disagree
Signature of Applicant

Clear
Signature of Co-Applicant

Clear
Date

Month Day Year
Date
Paved Paws Animal League

P.O. Box 26836

Greenville, SC 29616

pavedpaws@yahoo.com
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Adoption Application

Landlord Reference:

What other pets do you currently have?