Puppy Adoption Form

The Paw-Rent Village Adoption Application

Name of Pet You Wish to Adopt*

Reason for adopting the animal?

Your Name & Surname*

First NameLast Name

ID Number

Email Address*

Phone Number*

Area CodePhone Number

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Names & Ages of all permanent residents of your home (Adult/Children)

Do you own any pets?*

Pet Name(s)

Pet Breed(s)

Pet's behavior towards other dogs?

Is your current pet(s) vaccinations up to date?

YesNo1 outstanding

If your pet (s) vaccinations are not up to date please provide a reason why not?

Please provide your veterinarian's name and phone number:

A trip to the vet can be expensive, how are you planning to pay for them?

Are your current pet (s) sterilized?

YesNo

If your pet (s) have not been sterilized please provide us with a reason why not?

Are you planning on moving in the near future?

YesNo

You live in a

Do you own or rent your home?*

OwnRent

Do you have a yard?*

YesNo

If "Yes" to the above, is it fenced? please describe

What is your landlord's pet policy?*

If you rent, please provide your landlord's information here:*

My pool is

EnclosedOpenNo Pool

Did you have any sick animals on your property the last 6 Months?

YesNo

If Yes please explain what illness:

Where will the animal sleep?

InsideOutside

If you have other animals are you prepared to feed them separately if needed?

YesNoNot applicable

Have you ever surrendered a pet you own to any animal shelter?*

YesNo

Is anyone in your household allergic to the animal you are adopting?

YesNo

How many hours per day would the pet be alone?*

What type of food will feed them?

How many times a day will you feed your new pet?*

If you have to leave town in case of a emergency or planned, where would your pet stay?*

How would you deal with behavioral issues such as barking, chewing, destructive behavior, bathroom accidents indoors, unruly leash behaviors in your pet?*

If you require behavioral assistance do you agree to contact us?

YesNo

Do you agree to enroll your new pet in socialization / Puppy classes and commit to teaching the necessary basic obedience?

YesNo

Do you agree the pet should always wear a collar and ID tag?

YesNo

If the animal gets lost what steps will be taken?

Would there be any reason to give up the animal do you agree to contact us first?

YesNo

Are you aware of and can you manage the cost of caring for the animal?

YesNo

Have you ever been convicted of an animal related crime, such as cruelty to animals, animal theft, or animal abandonment?*

YesNo

Have you discussed the adoption with the whole family?

YesNo

By checking the box below, you understand the terms of this form and adoptee. You hereby agree that you will not use this animal in any sort of fighting, breeding, or cruelty. You will love and care for this animal for the rest of its life, and you are ready to commit to that.

I agreeI dont agree

You also agree, that if for any circumstances you can no longer provide love and care for this animal, you will contact an admin of the group and explain your situation before taking the animal to a shelter.

I agreeI don't agree

You confirm that the information provided on this form is true and correct and tat you agree that a home inspection may be carried out.

I agreeI don't agree

The applicant, according to our adoption protocol and regulations hereby agrees and acknowledged that by submitting this application, does not guarantee the successful adoption of the animal applied for here in.

I agree

You take note that all adoption paper work including payment on approval needs to be submitted before the hand over of the animal can take place.

I agree

Signature of Potential Pet Parent*