Foster Care / Adoption Application
This Application Is For:
*
Foster Care
Adoption
Date
*
-
Month
-
Day
Year
Date
Pet Name or Breed
Sex
Please Select
Male
Female
Description
Identification
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Home Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Cell Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Employment
Employer
*
Position
*
How long?
*
Business Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Housing
*
Rent
Own
Length of time at current residence
*
Landlord's Name (Renting Only)
Landlord's Contact Number (Renting Only)
Please enter a valid phone number.
Format: (000) 000-0000.
Are pets allowed? (Renting Only)
Please Select
Yes
No
Not Applicable (Own Home)
Household Members
Number of Adults in the household
*
Number of Children in the household
*
Age range of Children in household (Youngest to Oldest - Example 7 to 15)
Name of Spouse / Domestic Partner / Roommate
First Name
Last Name
Anyone in your house allergic to dogs?
*
Yes
No
Prior Pet History
List the animals that have been part of your family during the last 10 years. Indicate the current status of each animal.
Pet's Name
Species
Cat
Dog
Other
Current Status
Still with me
Lost/ran away
Euthanized
Died of natural causes (not euthanized)
Sold
Gave away
Unknown or none of the above
Pet's Name
Species
Cat
Dog
Other
Current Status
Still with me
Lost/ran away
Euthanized
Died of natural causes (not euthanized)
Sold
Gave away
Unknown or none of the above
Pet's Name
Species
Cat
Dog
Other
Current Status
Still with me
Lost/ran away
Euthanized
Died of natural causes (not euthanized)
Sold
Gave away
Unknown or none of the above
Pet's Name
Species
Cat
Dog
Other
Current Status
Still with me
Lost/ran away
Euthanized
Died of natural causes (not euthanized)
Sold
Gave away
Unknown or none of the above
Pet's Name
Species
Cat
Dog
Other
Current Status
Still with me
Lost/ran away
Euthanized
Died of natural causes (not euthanized)
Sold
Gave away
Unknown or none of the above
Pet's Name
Species
Cat
Dog
Other
Current Status
Still with me
Lost/ran away
Euthanized
Died of natural causes (not euthanized)
Sold
Gave away
Unknown or none of the above
Pet's Name
Species
Cat
Dog
Other
Current Status
Still with me
Lost/ran away
Euthanized
Died of natural causes (not euthanized)
Sold
Gave away
Unknown or none of the above
Are your Current Pets?
Up-to-date on vaccines?
*
Yes
No
No Current Pets
Spayed or Neutered?
*
Yes
No
No Current Pets
On Heartworm Preventative?
*
Yes
No
No Current Pets
Name of Veterinarian or Practice
*
Veterinarian Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Where will this pet spend most of its time?
*
Please Select
Crate
Indoors
Outdoors
Garage
Basement
Where will the pet stay while you are on vacation?
*
Signature
By my signature below I authorize "For the love of Woofers, Inc." and or Partners for Animal Welfare Society, Inc. (P.A.W.S.) to perform the following:
I authorize your veterinarian(s) to check the care and history of all listed pets on this form.
*
I Agree
I Do Not Agree
If renting, I authorize you to contact the landlord to check that permission has been given to keep pets on the premises.
*
I Agree
I Do Not Agree
I am not renting (Not Applicable)
Employer Confirmation
I authorize you to confirm employment.
I authorize you to contact my employer to confirm employment.
*
I Agree
I Do Not Agree
Signature
*
Submit
Submit
Should be Empty: