PACA Dog Adoption Application
To be considered for an adoption, you must meet the following requirements: 1. Be at least 18 years of age. 2. Have legal identification with current address. 3. Be able to verify that you can have pets where you live. 4. Be financially able to provide for the animal’s needs, including medical care when needed. NOTE: This is an adoption, not a sale. PACA/AAR has the right to refuse any person at any time. PLEASE MAKE SURE TO CLICK SUBMIT AFTER COMPLETING THIS FORM.
Name
*
First Name
Last Name
E-mail (Please add PACADOGS@AOL.COM to your contacts)
*
Confirmation Email
example@example.com
Phone Number (CELL NUMBER IS BEST AS WE MAY TEXT YOU)
*
-
Area Code
Phone Number
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Name of Dog(s) Desired:
*
Dog or Puppy?
Please Select
Dog
Puppy
What attracted you to this dog?
*
This dog is for:
*
Please Select
Self
Child
Gift
Other
Type of dog desired:
*
Please Select
House Pet
Watch Dog
Outdoor Dog
Other
Type of housing:
*
Please Select
Single Family Home
Military
Apartment
Condominium
Mobile Home
Townhouse
Do you rent or own your housing?
*
Please Select
Own/Mortgage
Rent
How long have you lived at this location?
*
Name and phone of landlord if renting
If renting, will you provide written permission from the landlord to have this dog?
Occupation of self and/or partner
*
Employer
*
How long have you been employed here?
*
Pets currently living in your home
Pet #1 - Type of Pet
Please Select
Dog
Cat
Rodent
other
Pet #1 if a dog what breed(s)?
Is pet #1 spayed or neutered
YES
NO
Pet #1 Age
Pet #1 Male or Female?
Female
Male
Pet #1 Energy Level
Low
Medium
High
Pet #2 Type of Pet
Please Select
Dog
Cat
Rodent
Other
If Pet #2 is a dog, what breed?
Pet #2 Male or Female?
Female
Male
Pet #2 Age
Is Pet #2 Spayed or Neutered
YES
No
Pet #2 Energy Level
Low
Medium
High
Please list any other pets
Where do your pets stay at night?
*
Where do your pets stay during the day?
*
Do you have free roaming poultry or livestock?
*
List pets you have owned in the past that are no longer living with you
Please list this information about Pet #1 (no longer living with you): Cat or Dog, Breed if Dog, How long you had pet, what happened to the pet?
Please list this information about Pet #2 (no longer living with you) : Cat or Dog, Breed if Dog, How long you had pet, what happened to the pet?
Please list any other pets in the past five years that are no longer living with you and why.
Do you have a fenced or walled yard?
*
Please Select
Yes
No
Type of Fence
Chain link
Cinder Block
Wooden/Vinyl/Solid Metal
Livestock fence
Other
How tall is your fence or wall?
Do you have a doggy door?
*
Yes
No
How many hours a day will the dog be left alone?
*
Where will the dog stay when left alone?
*
How will the dog be confined to your property?
*
In the house
Outdoor Kennel
Fenced Yard
Chained
Patio Area
Other
Do you have a pool?
*
No
Yes
If you have a pool, how is it secured from pets?
Are you aware your new pet may need house training and/or other training in their new home?
*
Yes
No
How will you exercise your new dog?
*
Do you plan to take your new dog to obedience classes?
Yes
No
Only if needed
Are you aware pets need yearly vaccinations and may require other veterinary care from time to time?
*
Yes
No
Name and phone of your veterinarian
Do any of your pets ride in an open pick-up truck bed?
*
No
Yes
Under what circumstances would you NOT keep this pet?
*
Divorce
New baby
Allergies
Job Change/ Moving
Got another pet
Can't afford vet bills
Doesn't get along with other pet
None
Other
Number of Adults in Household?
*
How many minors live in the household? What are their ages?
*
Would you be willing to allow a PACA/AAR representative to do a home visit prior to adoption or any time after adoption?
*
Yes
No
Animals going to a new home will need time to adjust to their new surroundings. Please realize it will take about 2 weeks for a new pet to start accepting everyone, especially another pet(s).
Do you understand that pet ownership is a lifetime commitment to provide care (including veterinary care) and a permanent, safe home for the life of your new pet?
Yes
No
Puppy Adoption Requirements:
If I am applying for a puppy, I understand that a puppy will require vaccinations and spay/ neuter BEFORE the final adoption is approved by PACA. Until the adoption is finalized via signing of the adoption contract by a PACA representative, the puppy will remain property of PACA. If I fail to get the required vaccinations or spay/neuter performed at the vet of PACA's choice, or pay for these procedures at a vet of my choosing and supply PACA with required paperwork, I agree and acknowledge that PACA may reclaim their puppy. My signature below states I have read and agree to the puppy adoption requirements.
PLEASE MAKE SURE TO CLICK "SUBMIT" BELOW THE SIGNATURE BLOCK
Date
*
-
Month
-
Day
Year
Date
No warranty or representation of any kind is made by PACA/AAR as to the health, disposition, or suitability of this dog as a domestic animal or, specifically as to any hazard it may present to known or unknown adults, children, or other animals or property. Should any dog on a trial period or adopted from PACA/AAR create a hazard to persons or property or cause injury to either, Applicant or Adopter agrees to hold blameless PACA/AAR, its agents, board of directors, staff, volunteers, representatives, heirs and assigns, in perpetuity. I certify the answers to this questionnaire to be true and that any false information may result in nullifying the adoption. Sign here
*
Two week trial period commencing on (date)
blanks
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CLICK HERE WHEN DONE TO SUBMIT FORM
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