2nd Hand Paws Animal Rescue
Adoption Application
Dog's name
Today's date
Name
First Name
Last Name
Email
example@example.com
Date of birth
Address
Street Address
Street Address 2
City
State / Province
Postal / Zip Code
County
Phone Number
-
Area Code
Phone Number
Employer's name
Employer's phone number
Do you live in a:
House
Condo
Apartment
Mobile home
Townhouse
Other
Do you:
Own
Rent
Live with family
Property owner or landlord's name:
Property owner or landlord's phone number:
Are you a first time pet owner?
Yes
No
Please tell us about each of your pets over the past five years. Include their name, breed, if they were spay/neutered, and age:
If you no longer own any of these pets, please tell us why:
In the last year, has a dog or puppy gotten sick or died on your premises of distemper, Parvo, or unknown causes?
Yes
No
Veternarian's name:
Veterinarian's phone number:
Who will be the primary caretaker for your new pet?
Why do you want to adopt a pet?
Family pet
Gift
Protection
Child's pet
Hunting
Other
Are you willing to attend obedience classes at your own expense(prices ranging from $80-$200)?
Yes
No
Are there children living in or visiting your home?
Yes
No
If yes, please list their ages:
How many adults reside in the home?
Does anyone in the home have allergies to pets?
Yes
No
Unsure
If yes, who and how do you plan to deal with this?
Where will your new pet spend the majority of it's time?
Inside
Outside
Where will your new pet be kept when you're not home?
Loose inside
In a crate inside
In a fenced backyard
Outdoor kennel
Tied to a dog house
On a chain
Other
Is your yard fenced?
Yes
No
Partially fenced
Type of fencing:
How high?
How much time will your pet spend alone each day/night?
Are you willing to make a lifelong commitment, which could be 10-15 years, for your pet including medical care, grooming, proper diet, exercise, companionship, and love?
Yes
No
What reason would cause you to give up the pet?
If you had to give up this pet what would you do?
Rehome
Return to 2nd Hand Paws
Take it to a shelter
Sell it
My new pet should get along with:
Dogs
Cats
Kids
Small animals
Farm animals
Other
Do all household members understand that it takes time for a pet to adjust to a new environment?
Yes
No
Are you willing to tolerate accidents while the dog adjusts to his or her new home?
Yes
No
What kind of solutions would you be willing to try if housebreaking accidents continue after two weeks?
Would you object to our verifying any of the information you have provided on this application?
Yes
No
Would you object to our visiting your home prior to adoption or as a follow up visit?
Yes
No
Please list two personal references, including their name, address, phone number, and their relationship to you:
Submit
Should be Empty: