Foster Care / Adoption Application

Foster Care / Adoption Application
This Application Is For:*

Foster CareAdoption
Date*

MonthDayYear
Date
Pet Name or Breed
Sex
Description
Identification
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Phone*
Please enter a valid phone number.
Cell Phone*
Please enter a valid phone number.
Email*
example@example.com
Employment
Employer*
Position*
How long?*
Business Phone Number*
Please enter a valid phone number.
Housing*

RentOwn
Length of time at current residence*
Landlord's Name (Renting Only)
Landlord's Contact Number (Renting Only)
Please enter a valid phone number.
Are pets allowed? (Renting Only)
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 NameLast Name
Anyone in your house allergic to dogs?*

YesNo
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

CatDogOther
Current Status

Still with meLost/ran awayEuthanizedDied of natural causes (not euthanized)SoldGave awayUnknown or none of the above
Pet's Name
Species

CatDogOther
Current Status

Still with meLost/ran awayEuthanizedDied of natural causes (not euthanized)SoldGave awayUnknown or none of the above
Pet's Name
Species

CatDogOther
Current Status

Still with meLost/ran awayEuthanizedDied of natural causes (not euthanized)SoldGave awayUnknown or none of the above
Pet's Name
Species

CatDogOther
Current Status

Still with meLost/ran awayEuthanizedDied of natural causes (not euthanized)SoldGave awayUnknown or none of the above
Pet's Name
Species

CatDogOther
Current Status

Still with meLost/ran awayEuthanizedDied of natural causes (not euthanized)SoldGave awayUnknown or none of the above
Pet's Name
Species

CatDogOther
Current Status

Still with meLost/ran awayEuthanizedDied of natural causes (not euthanized)SoldGave awayUnknown or none of the above
Pet's Name
Species

CatDogOther
Current Status

Still with meLost/ran awayEuthanizedDied of natural causes (not euthanized)SoldGave awayUnknown or none of the above
Are your Current Pets?
Up-to-date on vaccines?*

YesNoNo Current Pets
Spayed or Neutered?*

YesNoNo Current Pets
On Heartworm Preventative?*

YesNoNo Current Pets
Name of Veterinarian or Practice*
Veterinarian Phone Number*
Please enter a valid phone number.
Where will this pet spend most of its time?*
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 AgreeI 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 AgreeI Do Not AgreeI am not renting (Not Applicable)
Employer Confirmation

I authorize you to confirm employment.
I authorize you to contact my employer to confirm employment. *

I AgreeI Do Not Agree
Signature*

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Foster Care / Adoption Application

Identification

Employment

Household Members

Prior Pet History

Are your Current Pets?

Signature

Employer Confirmation