PAWSIBILITIES RESCUE
Located in Port Orange, FL
Adoption Application
Who are you looking to adopt?
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Pet Name
Adoptee First and Last Name
Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number (Mobile)
*
-
Area Code
Phone Number
E-mail
*
example@example.com
Do you own or rent?
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Own
Rent
Do you have a fenced in yard?
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Yes
No
Are there any children in the home? (If yes, please list ages)
Yes
No
Other
Will you crate your pet?
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Yes
No
How many hours of the day will the pet be alone at home?
*
If you have to leave town, emergent or planned, where will your pet stay?
*
How will you deal with behavioral issues such as barking, chewing, destructive behavior, bathroom accidents indoors, or unruly leash behavior in your pet?
*
Do you own any other pets? If yes, how many? (Cat or dog)
*
What is the breed of your pet?
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What is your pets disposition and behavior toward other dogs?
*
Is your pet male or female?
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Male
Female
Is your pet spayed / neutered?
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Yes
No
Is your pet used to other pets?
Yes
No
Other
Do you have a regular veterinarian?
*
Yes
No
Veterinarian’s name
*
Have you ever been convicted of an animal related crime, such as animal cruelty, animal theft, and or animal abandonment? (If yes please explain in detail)
*
*
By clicking the submit button, I agree to Pawsibilities Rescue adoption process, will undergo a homecheck, and interview at the discretion of Pawsibilities Rescue. By clicking the submit button, I understand Pawsibilities Rescue will check my references including veterinary and personal. By clicking the submit button, I understand that if I no longer want my pet, or am no longer able to care for my adopted pet at any time, I will be directed to surrender my pet back to Pawsibilities Rescue and provide transport to where Pawsibilities Rescue deems appropriate. By clicking the submit button, I verify all of the above information is true and accurate.
Signature of Potential Pet Parent
*
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