BORDER PAWS OF THE RGV ADOPTION/FOSTER APPLICATION

NAME

PHYSICAL ADDRESS

CITY

STATE

ZIP

PHONE NUMBER(S)

E MAIL

example@example.com

DRIVERS LICENSE#

STATE ISSUED

OCCUPATION

EMPLOYER & CONTACT

WORK ADDRESS

LENGTH OF TIME EMPLOYED

ARE YOU OVER 21 YEARS OLD?

Name of Dog

What are you looking for in a dog? What do you most like about your dog of interest, if applicable?

What do you like most about having a dog? What do you like the least?

Who are you adopting the dog for?

Who will be the primary caregiver of the dog?

Type of Residence

HouseApartmentCondo/TownhomeMobile Home

Do you rent or own?

If renting, please provide contact info to your landlord below:

How long have you lived there?

Previous address and length of time?

Please list all persons living with you, age, and relationship

1.

2.

3.

5.

6.

Please list any companion animals currently living in this household.

Name, Cat or Dog (breed). Sex. Age. Spayed/Neutered?

1.

2.

3.

4.

5

Does anyone in your household have animal allergies?

Do you have a backyard?

If yes, is it enclosed?

If a fenced yard, how high is the fence?

If you have no fence, how will your dog relieve/exercise her/himself?

Have you ever had a dog previously? (Please provide a brief history. If deceased, please state name, breed, age and date of death and cause of death if known)

Have you ever taken a pet to a shelter? If yes, please explain why and when.

What is your household activity level? (Active, Medium Active, Low Active, Not Active, Couch Potato)

Does anyone in the household smoke?

How many hours are you gone a day?

Do you travel often? If yes, who will care for your pet when you travel?

How many hours a day will your new dog be alone?

Where will your new dog be kept during the day?

Where will your dog sleep?

Who will walk your new dog and how often?

Who else will be spending time with your new dog?

What sort of training do you plan on providing?

Would you object to a visit to your home or video conferencing your home before and after the adoption is completed?

If you became ill, disabled, unemployed or died, who would physically and financially support this animal?

Name

NamePhone Number

Your Name

Address

Phone

Personal References: Please provide names, relationship, phone numbers and email addresses of 2 people NOT RELATED TO YOU:

2 people NOT RELATED TO YOU

Who is your local veterinarian?

Name

Complete Address

Tel. No.

Vet records are under the pet(s) names of

ADOPTION FEE/DONATION (FOR ADOPTERS ONLY) There will be an adoption / donation fee ranging from $300-$600 with a refundable sterilization deposit of $100 for unaltered pets (typically dogs under 6 mos of age), returnable within 10 days of proof of sterilization of animal. Adoption fee includes vaccinations (rabies for any dog over 12 weeks of age, minimum of two DAPPV-1 vaccinations for dogs under 6 mos and a minimum of one DAPPV-1 vaccine for dogs over 6 mos), deworming, flea/tick prevention & transport fee. 4DX tests can be done upon request to screen for blood borne illnesses such as heartworms and tick diseases. If positive, treatment will be initiated prior to adoption and expected to continue until dog is cleared by your personal vet. Please note, puppies under the age of 6 months will not be altered nor are they eligible for 4DX screenings. It will be your responsibility to have your pet altered and provide a certificate of proof after pet has been spayed/neutered prior to animal reaching 8 mos of age. It is recommended that you take your new pet to your veterinarian within 72 hours of receiving your pet.

Do you agree?

By typing my name below, I certify that the above information is true and accurate to the best of my knowledge, and I understand that completion of this form in no way guarantees my abilityto adopt a dog. I further understand that completion of this form is only the first step in the adoption process and that, should I wish to complete this process, a signed contract will be executed an in- home screening may follow.

Name

Signature

Date