Date
of Application:
Applying to ADOPT ONLY FOSTER ONLY
FOSTER/THEN ADOPT (Choose all that
apply)
*Adopt Only means you are
interested in adopting your pet as a permanent addition.
*Foster Only
means you do not want to add a permanent addition at this
time.
*Foster/Then Adopt means you are wanting to add a permanent
addition but would like to foster a pet, then consider permanent
adoption when the right pet for you comes along.
Name of Dog You are interested
in: (if you are
unsure, please list open in the field provided)
Applicant Name:
Email Address:
Home Address:
City:
State:
Zip:
Home Phone #:
Employer:
Employer's Address:
Employer's City: Employer's State:
Business Phone #:
Cell/Pager Phone #: Cell Pager Have Neither
Please provide us with contact information for two personal references (non-relatives) that we may contact on your behalf:
Name & Phone Number:
Name & Phone Number:
Co-Applicant
Co-Applicant
Name:
Spouse Roommate Other, Please List:
Employer:
Business Phone #:
Home and
Family Information
Number of
adults in home:
Ages of
Adults:
Number of children in Home:
Ages of children:
Estimate how
often you have visitors in your home:
How
would you describe your household activity level?
Type of Home
You Live In:
House
Condo
Apartment
Duplex
Other, Please List:
Do you OWN or RENT your
home?
If you rent, you will be required to have written permission from
your landlord.
Landlord's name and telephone number is: (Please list
name, phone, full mailing address)
Do you have a fenced
in yard?
Fully Fenced
Partially
Fenced
No Fence
If you have
a fence, Please list the type and height:
Pet
Information
Do you currently have
any pets: Yes No
Please list
all current pets: (breeds, sex, age)
Where are
they during the day:
Where do
they sleep at night:
Are your
current pets spayed or neutered? Yes No N/A
If no, why not?
Are your
current pets vaccinated yearly? Yes No N/A
If no, why not?
Are
your current pets on monthly heartworm prevention? Yes
No N/A
If yes,
what type?:
Pro Heart
Interceptor
Heartgard
Sentinel
Other:
If no, why not?
Are your
current pets on flea prevention? Yes No N/A
If
yes, what type?
If
no, why not?
What food do
you feed your current pets?
Name of your Veterinarian:
Clinic Name:
Clinic Address:
City:
State:
Phone #:
Have you ever given up, sold, or taken a pet to the shelter? Yes No
If yes, please
explain:
Have you ever bred (either
intentionally or unintentionally) a pet? Yes No
Please explain:
Please list
any pets you have had in the past:
What happened to them?
Adoption
Questionnaire
Would
you accept a pet that has been abused? Yes No Maybe
Has special
needs (such as blindness or
deaf)? Yes No Maybe
Minor Health Problems (allergies, skin problems,
etc)? Yes No Maybe
Major Health Problems (heart murmur, cancer, etc)? Yes No Maybe
Do you
prefer MALE, FEMALE, or EITHER?
What age would you prefer?
Are you
aware of the importance of keeping a pet on a leash or in a
fenced area when it goes outside?:
Yes No
Most small breed pets adopted through PPR, Inc. are primarily house dogs. They can be kept outdoors for short times in a kennel or dog house with an attached run. Or they can use a
doggie door to go in and out. They CANNOT be chained, tied outdoors or
left outdoors alone for long periods unsupervised. Do you agree to these
conditions?: Yes No
Are
you willing to follow your local ordinances pertaining to owning/housing
an animal?
(ex: leash laws, required
vaccinations, dog licenses, etc)? Yes No
Are you
willing to provide a collar with a tag bearing your name, address, phone
number, etc. on your pet at all times?
Yes
No
Will
someone be home during the day with your pet? Yes
No
Do you
have or would you consider using a doggie door to allow your pet access to your fenced yard?
Yes No
How
many hours will your pet spend alone?
Where will your pet be kept when
alone?
Where will your
pet be kept when you are home?
Where will your pet sleep at night?
How do you feel about
allowing your pets on your furniture (such
as couch, bed, chairs, etc.)
Who will be responsible for the care of your pets?
Will you provide
regular grooming for your new pet? Yes No Maybe If Needed
Will you
provide regular and emergency veterinary care? Yes No Maybe If
Needed
Will you provide monthly heartworm prevention? Yes No
Maybe If
Needed
Will you provide monthly flea and tick prevention? Yes
No Maybe If
Needed
Will you provide a high quality food (ex: I
ams)? Yes No Maybe If
Needed
In addition
to a regular life at home,
would your pet:
Walk routinely with a family
member
Go to obedience classes
Go
to work with you
Travel with you
Be a playmate for other
pets
Be a playmate for your
children
Other, Please List:
Are
you familiar with crate training as a method of housetraining? Yes No Not
Sure
Would you be interested in learning the crate training
method? Yes No Maybe
Will you accept a pet
that is not fully housetrained? Yes No Maybe
Will you work with your
new pet on housetraining? Yes No Maybe
(Please know that any new pet will take time to adjust to
its new home, including on housetraining. Expect and be prepared for
some potty accidents, however, if the pet you are adopting is not fully
housetrained, we will let you know in advance.)
Will you allow time (2 weeks to a month) for your new
pet to adjust in your home? Yes No Maybe
Would you consider putting a pet
down versus treatment in the case that you were unable to afford
treatment? (ex: major surgery, cancer treatment, etc.) Yes
No
Maybe
Only if vet
recommended
If this pet does not work out as planned at your home, will
you agree to return it only to Precious Paws Rescue, Inc. and no other third party?
Yes No
What are any
reasons you can think of that would make you want to give up your
pet?
Are
you or your spouse in the military?
Yes
No
Check all that
apply:
Active Duty Reserves Guard Retired
Military
Air Force Army Marines Navy
If yes, if
your duty station changes, would you do everything possible to keep your
pet? Yes No
Are
you committed for life to your new pet? Yes No
(The average pet lives 14-16+ years, so you must consider where you will be plan to include your pet in your life. We would prefer adoptions to
be permanent however, we understand that certain situations occur that
are beyond your control. We require that if you for any reason must
give up your pet, that it is returned to Precious Paws Rescue, Inc. and no other third party without first receiving our approval.)
*Do you certify that all answers you have
provided here are true and accurate? Yes No
*Do you certify that you are over the age of 21? Yes No
Any
Additional Comments:
By
submission of this application, I/We unequivocally state that all
statements and answers given in said application are the complete truth.
Any misrepresentation of the truth in this application will invalidate any
subsequent adoption agreement and will give Precious Paws Rescue, Inc. the right to reclaim the adopted pet without refund of the adoption
fee. Submission of this online application constitutes agreement and acknowledgement by the Adopter of the PPR, Inc. Adoption Policies, Terms & Conditions.