PAWS (Public Animal Welfare Society, Inc.)    
P
O Box 24651, Cleveland, OH 44124  Phone: 440.442.7297      

www.pawsohio.org                                                                                                                                                                         

                                                                                     DOG ADOPTION APPLICATION

 

DATE    

 

 

 

Thank you for filling out this profile.  The information you provide will help us to help you find the dog that best matches you and your family.  It is a requirement that you fill out every field.  if you cannot answer or don't know how to answer, please put in N/A.

 

Name and address

Name (first, last)

Home address Apartment number  

City State   Zip Code   County 

Home Phone    Cell Phone   Work Phone 

E-mail Birth date Age

 

 

BACKGROUND INFORMATION

Do you own or rent your home?    own rent        House  Condo Mobile Home Apartment
        How many years have you lived at this address?
less than one year      1-3 years       3 years or more
        If less than three years, where did you live before?

        If you rent, what is your landlord’s name?
    phone number
        If you rent, are you allowed to own a pet?        
yes     no 
        If you rent, do you have to pay an additional security deposit or pet fee?   
yes    no 
        Are you or any family members allergic to dogs?   
yes    no 
        Do you have any children under the age of 5?     
yes    no

 

How did you hear about us? Previous adoption             Newspaper               Word of mouth

                                                 PAWS website                  Special Event            Other

 

Is there a certain dog that you are interested in?  If so, which one?

What kind of pet are you looking for?    puppy            adult dog

 

FAMILY INFORMATION

Who do you live with?   Spouse  Parents   Children   Significant Other   Roommates   Alone

Number of adults in household  5+   List adult's ages

Number of children in household 0 5+   List children's ages

Any family members suffer from pet allergies?   Yes   No    If yes, allergic to:  Dogs   Cats   Both

What qualities are you looking for in your dog/puppy? (check all that apply)

   Size preference  Small (5-20lbs)   medium (20-50lbs)  large (50-100lbs)  any size

   Age preference   2-4 months   4-12 months   1-4 years    5-7 years   Senior    no preference

   Personality traits    playful   easily trained   fully trained   good with kids   athletic   protective

                                   will hunt   companion for other animals   mellow   laid back   energetic  

                                   loves to spend time outdoors

 

PET INFORMATION

List all present and past pets you have been responsible for as an adult.

1. Name dog/cat    spayed/neutered indoor/outdoor/both

  living/deceased , if deceased, the cause

2. Name dog/cat    spayed/neutered indoor/outdoor/both

  living/deceased , if deceased, the cause

3. Name dog/cat    spayed/neutered indoor/outdoor/both

  living/deceased , if deceased, the cause

 

If you currently have pets, what is the name and phone number of your veterinarian?

Name   phone

Do you give us permission to contact them?   yes    no

 

List all members of your household and which one will be primarily responsible for the care of this pet.

Name Age How do they feel about getting a dog?

Name Age How do they feel about getting a dog?

Name Age How do they feel about getting a dog?

Name Age How do they feel about getting a dog?

Name Age How do they feel about getting a dog?

 

Do you have a completely fenced in yard?   yes  no

How do you plan on exercising your dog?    in my yard  dog park   walks   other

What type of lifestyle do you want your dog to live?     inside   outside

Where will your dog stay while you are at work? 

Where will your dog sleep? 
Is this dog/puppy for you or a third party?

Check any of the following reasons you would give your dog away.  Please read this section carefully.

fleas  getting married/divorced  allergies  too expensive  chews or destroys household objects

children will no longer take care of it  having a baby  found a new place to live and they don't allow pets

sheds too much  having accidents in the house   other 

How long do you expect a dog to live?    years

Would you have any objections if a PAWS adoption volunteer made a follow-up visit to the dog's new home after the adoption?

          yes  no

 

PERSONAL REFERENCES

List the names, relationship, and telephone numbers of three persons that are not related to you. 

 

Name   Relationship   Phone

Name   Relationship   Phone

Name   Relationship   Phone

 

What are your plans for the dog when you go away on vacation?

 

Applicant's electronic signature   Date

 

PAWS Thanks you for your interest in one of our rescues. 

We here at PAWS reserve the right to deny any application without explanation