LADA Paws Rescue Adoption Application Form

Please allow up to 72 hours for a application result. Adoption applications are reviewed by two volunteers and we are working as quickly as possible to set up meet and greets. Thank you for your patience.

Name*

First NameLast Name

Name of animal interested in?*

Are you over the age of 18?*

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number (Mobile)*

Area CodePhone Number

Phone Number

Area CodePhone Number

E-mail*

example@example.com

Any children in the home

yesno

If so, what are their ages?

Do you live with any other adults

yesno

I / We live in a

Do you have a fenced in yard?

YesNo

How high is your fence?

What type of fence do you have?

Do you have any pets in your home?*

How many?

Is your pet male or female?

FemaleMaleBoth

Is your pet spayed / neutered?

YesNo

What breed is your dog/cat? Please list breeds and ages of every animal in the household.

Where does your pet stay (be confined) while you are out?

Do your pets use a crate?

Yesnono, but open to trying it

Is your pet used to other pets?

YesNo

How do you discipline your pets? (describe)

Number of hours (average) pet(s) spends alone

Do you have a regular veterinarian?

YesNo

Veterinarian’s Name

Are your animals up to date on vaccines

YesNoRabies only

Clinic Name

Clinic's Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Clinic's Telephone*

Area CodePhone Number

LADA Paws Rescue Adoption Application Form

Applicant Details

Pet's Details