The Paws Unlimited Foundation
Your full name and age:
Home Phone Number
Your work phone: _
How many hours a week do you work?
Name and age of spouse: Age:
Names and ages of all children living with you:
Who, beside immediate family and/or children, reside with you? Please name them, list their relationship and ages:
Are you seeking other avenues to attain a Dog such as other Rescues or Facilities?
If so please explain, and give the Name and phone # of that organization?
Is there a certain Dog you are interested in, if so, who? If yes, and he/she is no longer available, would you be interested in another?
Would a male or female dog fit better in your home?
Age range? Any other criteria for dog you'd like to adopt?
Do you rent or own?
If you rent, please provide the name and phone number of your landlord:
Is this a house, condominium, apartment, or mobile home?
How long have you lived at this address?
If less than two years, please list your previous address and landlord:
Do you know the city animal ordinances/licensing procedures in your area?
Do you have a city or county ordinance that limits the number of dogs you are allowed to have in your home?
If yes, how many are you allowed to have?
Do you have a fenced yard?
If yes, what type of fence is it and how tall?
Is the fence secured underground as well?
If you do not have a fence to you plan on putting one up?
If no, do you have a kennel area?
If you do not have an outside kennel or fenced yard, please explain how you will allow for the dog to defecate/urinate?
Do you currently keep the gate padlocked?
Do you have a pool?
If yes, is it fenced separately?
Do you have a homeowners or renters insurance policy?
If so, what is the name of insurance company?
Will the dog be kept indoors or outdoors?
Please describe where and how the dog will live, on a typical day:
Is someone home during the day? If not, where will the dog stay while you are gone?
How many hours per day will the dog be left alone and/or crated?
Do you have a crate?
If so, what type and size is the crate
If no, are you willing to purchase a crate, if needed?
Do you currently have any other pets? If yes, please describe the pets in detail and give names and ages of all pets:
If you have a current pet, is he/she an only pet? If so, for how long?
If you own or have owned a dog, is it/was it spayed or neutered and current on vaccinations? If not, please explain why:
Are your Dog’s or were any previous Dog’s on heartworm preventative? What type?
If you do not/did not give your dog’s heartworm preventative please explain why.
If applicable, approximate date of your current pet's last office visit?
If there were previous dogs, if so what happened to them?
Have you ever given any of your Pets away or surrendered them to anyone?
If so please give the name and phone number of the person to whom you surrendered the Pet.
Have you ever owned a dog ? if yes, please give names, breeds and ages and explain why they are no longer with you?
Do you belong to any Kennel Clubs, Obedience Clubs, or other dog-related clubs?
If yes, please list and describe
Please explain why you wish to adopt a dog ? :
What steps have you taken to learn about this breed and/or dog ownership?
We will attempt to provide you with an honest evaluation of temperament on any dog we adopt to you, do you realize that often times the complete history of the dog may not be known and you may encounter some behavioral problems?
Are you willing to work with us on correcting these problems?
Are you willing to take the adopted dog to obedience classes?
Why or why not?
What behavioral/training issues ‘can’ you deal with
What behavioral/training issues can you ‘not’ deal with?
If you were to return this (or any) dog, for what reason would it be?
What length of time do you feel is adequate to allow an adopted Dog to adjust to your home?
What length of time are you willing to give a Dog to adjust to your home?
How did you hear about us ?
Please list your Veterinarian’s name address and phone number, if you have recently changed Vet’s and it is less than one year; please also list the name and number of your previous Veterinarian.
I certify that the above information is true and I understand that prior to being approved for adoption, the above information will be verified. In all cases, a home visit will be required. I also agree to a personal interview with the rescuer , if required, to determine the suitability of my home/facility to care for a canine. I also understand that if at any time Rescuer feels the dog is not being cared for properly, or feel the dog is being abused, the Rescuer will take back possession of the dog. In the event that you can no longer keep the dog Paws Unlimited must be notified immediately. I understand and agree that falsification of any of the above information is grounds to disqualify my adoption application and nullify all adoption(s) and/or adoption agreements between the applicant and the Paws Unlimited Foundation . I understand my electronic signature is legal and binding. I authorize Paws Unlimited to attain any information needed from all above references.
Please initial here ( )
Applicant (s) signature: Date: