Paws Up Rescue Adoption Application

1

Paws Up Rescue LLC is an all-volunteer, foster based, non-profit, dog rescue organization dedicated to the rescue and placement of stray, neglected and abused dogs. Paws Up Rescue LLC is completely funded through fundraising efforts, public donations and adoption donations. All of our pets are cared for by foster homes and receive complete medical care, which includes disease testing, deworming, vaccinations, spaying/neutering and microchipping prior to their adoption.

Our adoption fee is $300 unless otherwise noted. Some dogs have been partially or fully sponsored. If you would like your adoption fee sponsored, please let us know in the "other notes" section.

2

This application is designed to help Paws Up Rescue LLC and yourself determine if a specific dog is the right one for you and your household. All adopting parties are required to complete this form prior to adoption. Incomplete applications will not be processed. Paws Up Rescue LLC reserves the right to deny any adoption based on answers to this questionnaire and/or interviews prior to adoptions!

3

Name of the DOG you are interested in:* This field is required.

4

Your full name:* This field is required.

5

Your age:* This field is required.

6

Street Address:* This field is required.We need your physical address

7

City, State, Zip* This field is required.

8

Home/Cell Phone:* This field is required.

9

Secondary Contact Phone:* This field is required.

10

E-mail:* This field is required.

11

Employer:* This field is required.

12

How long have you been employed with that company?* This field is required.

13

Are you interested in adopting or foster to adopt?* This field is required.

Adoption

Foster to adopt

14

3 character references AND phone numbers (can not be family members, must not live inside the home) APPLICATION WILL BE DENIED WITH MISSING INFORMATION * This field is required.

15

Are all members of your household in agreement with this adoption?* This field is required.

Yes

No

Don't Know

16

Please list all the names and phone numbers of all ADULTS in the household. (This includes, roommates, family and friends)* This field is required.

17

How many adults are in your household?* This field is required.

18

How many children are in your household?* This field is required.

19

If children, what are their ages?* This field is required.

20

Have your children been around animals before?* This field is required.

Yes

No

21

Who will be the pet's primary caregiver?* This field is required.

23

Do you own or rent?* This field is required.

Own

Rent

24

If rent, provide name AND phone number of landlord:* This field is required.

25

Are there any restrictions from your landlord or subdivision?

Number of pets

Size or weight restrictions

Breed restrictions

None

26

Do you have a fully fenced yard?* This field is required.

Yes

No

27

Height and type of fence* This field is required.If yes

29

Does anyone in your home have allergies to dogs or have asthma?* This field is required.

Yes

No

30

List any pets that will reside in the home with the adopted dog, breed, age* This field is required.Please include all information

31

Are all the pets in the home current on vaccinations? * This field is required.

32

If no, please explain why* This field is required.

33

How many of these pets are spayed/neutered?* This field is required.

34

If no, please explain why

35

Are your pets current on flea/tick and heartworm prevention? If yes, what brand?* This field is required.

36

If no, why?* This field is required.

37

List any pets you have previously owned. Where are these animals now?* This field is required.

38

Have you adopted from an animal welfare group before?* This field is required.

Yes

No

39

If yes, what group?* This field is required.

40

Have you ever given up a pet?* This field is required.

Yes

No

41

If yes, what were the circumstances?* This field is required.

42

Please provide the name and phone number of your current and/or previous veterinarian or clinic:* This field is required.

43

Do you have any trips planned in the next 3 months?

44

What type of personality do you want your pet to have? (i.e. calm, energetic, protective, couch-potato)* This field is required.

45

Are you aware of crate training?* This field is required.

Yes

No

46

Have you ever house-broken a dog or puppy before?* This field is required.

Yes

No

47

If the dog has an "accident" in your home, what type of correction do you plan to use?* This field is required.

48

How many hours each day will your new pet be home alone?* This field is required.

49

Where will your new pet sleep at night?* This field is required.

50

How will you supervise the dog's outdoor activity?* This field is required.

51

Where will your new dog stay when nobody is home?* This field is required.

52

What length of time will you allow your new pet to adjust to his new home?* This field is required.

53

Are you aware that a new environment is stressful for your pet, and they may exhibit uncharacteristic behavior?* This field is required.

Yes

No

54

Are you willing to work through your new pet's issues, if any?* This field is required.

Yes

No

55

Do you understand that a dog can be an 18 year commitment, and can cost $300 - $500 per year to care for?* This field is required.

Yes

No

56

Do you plan to take an obedience class with your dog?* This field is required.

Yes

No

Not sure

57

If yes, where? If no, why?

58

Are you aware that a large breed dog takes about two years to mature? Is this something you're prepared for?* This field is required.

Yes

No

59

What circumstances would lead you to give up your new dog?* This field is required.

60

If you had to give up your dog, what would you do with him/her?* This field is required.

61

Any other notes you would like us to consider?

63

I understand that a completed and approved application is required in order secure a meet and greet and an adoption fee must be paid and contract must be signed prior to adoption being final.

By signing below, you are agreeing the above information is truthful and accurate. You understand if found to be untrue at any time, the adoption will void and the dog will returned to Paws Up Rescue without incident.

64

In consideration of the risk of injury to myself and/or my dog/s while participating in any Paws Up Recue LLC meet and greet and/or adoption events (the "Activity"), and as consideration for the right to participate in the Activity, I hereby, for myself, my heirs, executors, administrators, assigns, or personal representatives, knowingly and voluntarily enter into this waiver and release of liability and hereby waive any and all rights, claims or causes of action of any kind whatsoever arising out of my participation in the Activity, and do hereby release and forever discharge Paws Up Rescue LLC, and their affiliates, managers, members, agents, attorneys, staff, volunteers, heirs, representatives, predecessors, successors and assigns, for any physical or psychological injury, including but not limited to injury, illness, and economical or emotional loss, that I may suffer as a direct result of my participation in the aforementioned Activity, including traveling to and from an event related to this Activity and health conditions of and relating to COVID 19.

I agree to indemnify and hold harmless Paws Up Rescue LLC, volunteers, agents and staff against any and all claims, suits or actions of any kind whatsoever for liability, damages, compensation or otherwise brought by me or anyone on my behalf, including attorney's fees and any related costs, if litigation arises pursuant to any claims made by me or by anyone else acting on my behalf. If Paws Up Rescue LLC incurs any of these types of expenses, I agree to reimburse Paws Up Rescue LLC.

65

SignatureBy signing this form, you agree all the information is true and correct.

Powered by Jotform SignClear