Adoption & Foster Application

Adoption & Foster Application

Complete this multi-section form to apply to adopt or foster with Southern Paws Rescue.
Applicant Information
Full Name

First NameLast Name
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
City / State / ZIP
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Household Information
Type of Residence

Other
Own or Rent
Landlord Permission to Keep Pets
How Long at This Address
Number of Adults in Household
Number of Children and Ages
Pet Experience & Preferences
Animal Applying For / Pet Name
Breed / Size Preference
Age Preference
Gender Preference
Do You Have a Fenced Yard?
If Yes, Fence Height / Details
Hours the Pet Will Be Left Alone Daily
Where Will the Pet Stay During the Day and Night?
Veterinary & References
Veterinarian Name & Clinic
Veterinarian Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Personal Reference Name (Non-Family)
Personal Reference Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Lifestyle & Commitment
Prepared for the financial responsibility of a pet?
Who will be responsible for daily care?
What arrangements would be made for the animal in the event of a change in circumstances such as relocation or financial hardship?
Reservation Fee & Policies Notice
Reservation fee policy: $300 for dogs and $200 for kittens and other animals. This fee is refundable/deductible upon completion of the adoption and secures the animal for up to one month.
Applicant initials
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Agreement & Declaration
Agreement Acknowledgements
Virtual Home Assessment Consent
Internal Use Only
Application Status
Reservation Fee Received
Amount Received ($)
Reviewed By

First NameLast Name
Date Reviewed

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Internal Notes
Should be Empty:

Adoption & Foster Application

Applicant Information

Household Information

Pet Experience & Preferences

Veterinary & References

Lifestyle & Commitment

Reservation Fee & Policies Notice

Agreement & Declaration

Internal Use Only