Paw-fect Pet Universal Application

Paw-fect Pet Dog Adoption Application
Name*

First NameLast Name
Date of Birth*

MonthDayYear
Date
Email*
example@example.com
Confirm Email*
example@example.com
Phone Number*

Area CodePhone Number
Confirm Phone Number*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Occupation*
Employer (optional)
What shelter are you applying to?*
Are you applying to adopt a specific dog?*
If yes, what’s the dogs name?
How many & to which rescues have you applied for a dog in the last year?
Household Information
Who will be the primary caregiver of the new pet? What is their age?*
Please list all people (including yourself) that will be living with your new dog*
Are all members of your household in agreement with this adoption?*

YesNoDon't Know
Housing Type*

HouseCondoApartmentTownhouseDormMobile HomeOther
Do you own or rent?*

OwnRentLive with Parents
If rent, provide name and phone number of landlord:*
Does your landlord allow dogs?*

YesNo
Are there any restrictions from your landlord or subdivision?*

Number of petsSize or weight restrictionsBreed restrictionsNone
Do you have a fence or designated outdoor area that is enclosed?*

YesNo
Describe fence/kennel, type, height, and approx. size
If no fenced yard/kennel, how will you handle your dog’s exercise and toilet needs?
When your pet is outside, what is available for them?*

Fenced in yardDog runTie outPatioBalconyOther
How long will your pet be OUTDOORS Unattended?*
Do you have a suitable dog crate?

YesNo
If so what type?
Current/Previous Pet Information
Is this your first pet as the primary caregiver?*

YesNo
Please List any Current Pets*
If you currently have pets, please describe their experience interacting with other animals:
Please list any previous pets you have had in the last 10 years*
Have you adopted from an animal welfare group before?*

YesNo
If yes, what group?
Have you ever surrendered an animal to a rescue or shelter, or lost a pet to something other than natural causes?*

YesNo
If yes, what were the circumstances?*
Are Your Current Pets Up-To-Date With Vaccines And Yearly Check-Ups? If No, Please Specify The Circumstances.*
Please provide the name, phone number, and address of your current and/or previous veterinarian or clinic:*
*REQUIRED for past or current pets. List vet clinic you have already been to in the past or are currently going to, not the one you plan on going to in the future. IMPORTANT please also call your vet clinic asap and let them know it is ok to release information to any shelter you plan on applying to so that your application can be approved much faster. If you do not call, they may not be able to approve your application before you want to come out.
Name of Pet and The Last Name The Pet Is Under At This Clinic*
Make sure to put down correct last name on file at this clinic or it will slow down the approval process.
New Pet Information
What annual vaccinations and routine care will your newly adopted pet receive?*
Are you willing to work with a dog who needs additional support (training or medical)?*

YesNo
What is your households typical daily schedule?*
Why are you considering adopting a dog?*
Companion for self, companion for family, gift for someone else, breeding, for protection, for a child, companion for other pet, replace previous pet, etc.
Where will you keep the dog when you are at home?*
Where will you keep the dog when you are not at home?*
Free range of house, crate, outdoor kennel/dog run, fenced in backyard, etc.
Where will the dog sleep at night?*
How will you discipline your dog? (Ex. Chewing on furniture, scratching, vocalizing, etc.)*
Please describe how you have/will housetrain a pet?*
What activities would you do with your new pet?
Obedience, Agility, Flyball, etc.
What behaviors are you and your family unwilling to tolerate regarding dog behavior and under what circumstances would you not keep the dog?*
Ex. House training struggles, barking, digging, chewing, allergies, animal grew too large, pet becomes ill, shedding too much, not obedient enough, divorce, new baby, illness in the family, moving, child doesn’t like or ignores pet
Sometimes Animals Do Not Adjust To Their New Environments Well. Are You Prepared To Spend Several Weeks, Perhaps Even Months, Waiting For Your New Pet To Adjust To A New Environment?*

YesNo
Are you willing and able to cover the costs of basic obedience training?*

YesNo
Is yes, where?
If a medical emergency arises, are you willing and able to cover that cost at your own expense?*

YesNo
If you and your family move in the future, what will your plan be to ensure adequate care for your dog?*
If you experience a major life change (medical emergency, change in marital status, birth of a child, etc.) what will your plan be to ensure adequate care for your dog?*
Please Provide First and Last Name and Phone Number for three references that are not related to you*
Is there anything else you would like to share?
I certify that the information provided in this application is complete and accurate to the best of my knowledge. I understand that any shelter reserves the right to deny my request to adopt an animal for any reason. I, along with the persons who accompany me, assume risk of injury which may be incurred as a result of my viewing any animal under a shelters care. I am willing to commit to owning a dog for the next 10-12 years.
Date*
Signature*

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Paw-fect Pet Dog Adoption Application

Household Information

Current/Previous Pet Information

New Pet Information