Dog Adoption Application

North Beach PAWS Dog Adoption Application

Applicants must be aged 18 or older, provide proof of address (i.e. utility bill) and have a photo ID.
Today's Date*
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Date of Birth:*

MonthDayYear
Date
Please list household members:
If you're interested in a specific dog, which one?
Please list current household pets:

What is your tolerance for: (High means it doesn't bother you, Low means you're prefer not to deal with it)

	Low	Medium	High
Sshedding / Grooming
Your current household activity Level
Barking
Training / Housebreaking

Please list dog breeds you've owned in the past:
How did you find out about us?
Will anyone be home with the pet during the day?
How many hours a day will the pet be alone?
What type of dog are you looking for?
Why are you wanting to adopt a dog?
Home Ownership

RentOwnOther
Are Pets Allowed

YesNo
Damage Deposit Required

YesNoN/A - I own my home
Is your yard fenced

YesNo
What type of fence
How tall is your fence
Size of yard

SmallMediumLarge
Where will you keep the dog during the day and at night?
Are you prepared to housebreak if necessary?

YesNo
Are you prepared to train the dog if necessary?

YesNo
Do you agree to keep the dog current on health check-ups and vaccinations?

YesNo
Do you agree to keep a collar on the dog and purchase a tag with your phone number and the dog's name?

YesNo
Do you agree not to tie or chain the dog as a primary means of confinement?

YesNo
Do all members of the household want this pet?

YesMostJust meI didn't ask
Who will care for this pet?
Is this pet a gift? If so, for whom? Please explain.
What will you do with this pet when you go on vacation?
If something happens to you and you are no longer able to care for this dog, do you have someone who will take care of it or will it come back to the shelter?*
Have you ever surrendered an animal to a shelter and/or given to another person? If yes, why?*
Veterinary Reference:
Clinic Name
Vet's Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Do you agree to allow pre and/or post adoption home checks?*
I have answered all the questions above truthfully and to the best of my knowledge. North Beach PAWS has the right to deny this application if any answer is found to be untruthful or purposefully misleading. Initial Here*
Signature*

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North Beach PAWS Dog Adoption Application

Veterinary Reference: