PAAWS Adoption Application

PAAWS
No Kill Animal Rescue
812-646-1148 - www.PAAWS.org
Facebook.com/PAAWSRescue
Pet Adoption Application Form
Name of animal*
Date of application*

MonthDayYear
Date
ALL Applicant's names*
1st Phone*
2nd Phone
Main applicant's E-mail*
example@example.com
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
How long have you lived at this address?*
Do you rent or own?*
Landlord's name and contact info. (Write N/a if you own it)*
What type of home? Please circle:*

Single familyApartmentCondoFarmMobile HomeOther
Do you have a fenced yard?*
Please describe the type of fence (Wood 4', chain link 6')*
Other family members in the home*
Ages of children*
NAMES and AGES of other pets in your home*
Are those pets spayed/neutered?*
Are those pets UTD on shots?*
What is the name of your Vet Clinic?*
Phone of Vet
If no other pets, names of previous pets (if none, write none)*
Date passed

MonthDayYear
Date
Previous Vet Used
Will you provide regular health care by a licensed vet?*
Place of employment?*
How Long have you worked there?*
Time spent away from home (hours)*
What is your reason for adopting this animal?*
Have you ever surrendered any pets?*
If you surrendered a pet before, Why?*
Where (in the home) will this animal be residing? (Crate, etc)*
Where will this animal spend the day/night?*
Do you agree this is an INDOOR pet and will only be outside for short periods of time?*
Who is the primary care giver of this animal?*
Reference: Name*
Reference: Phone #*
All of the information I have given is true and complete. This animal will reside inside my home as a pet; I will provide it with quality food, fresh water, indoor shelter, affection, and regular veterinary services by a licensed Veterinarian. I understand that if, for any reason, I am unable to keep this animal. I will contact PAAWS No Kill in order to surrender it.
Signature*
Date*

MonthDayYear
Date
Should be Empty: