Public Assistance for Public Adoptions

Your Name *

First Name Last Name

Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

Your E-mail Address *

Phone Number *

Area Code Phone Number

Work Phone

Area Code Phone Number

Other Phone

Area Code Phone Number

What are you trying to rehome? *

What is your pet's name? *

What sex is your pet? *

What is your pets date of birth, or approximate age? *

What is your pet's breed? *

Is this.... *

Your personal pet A pet you found Neighborhood stray

How long have you had this pet? *

If you have a dog you are listing, do you want to list online, attend adoption events, or both? (Unfortunately at this time we are unable to have cats attend adoptions in person.) *

Online only Adoptions only Both, when space allows

Why are you rehoming this animal? *

be as detailed as you can

What Veterinarian or Animals Hospital were they last seen at? *

type in none if unknown

Are they up to date on shots & vaccinations? (In order to attend or be listed, this is required) *

Yes No

Have they been neutered or spayed? (In order to attend or be listed, this is required) *

Yes No

Have they been tested for heartworms if dog and heartworms/FeLV/FIV if cat, and are they negative or positive (positive is not reason to lose hope) (In order to attend or be listed, this is required) *

Positive Negative Not Tested

If they are currently taking heartworm preventative, when is their next dose due?

Date

If you have their vet records please upload them here in pdf format or jpg/bmp/png format. If not, you can email them to caawsmail@yahoo.com by taking a picture of them, or other arrangements can be made to receive them.

What kind of food do they eat? How much, how many times a day? *

Are they good with cats? Dogs? Children? Check all that you know they are good with. If none check "none" *

Cats Dogs Children None Unsure

Please explain specifically how they react towards children, dogs, and/or cats. *

if unsure write unsure

Are they housebroken? *

Yes No Semi Crate Trained

Where does the animal live the majority of the time? *

Inside Outside Inside & Outside

Favorite Toys *

Balls Squeaky Plastic Stuffed Rubber

Please describe their personality so it can be conveyed to those looking on our site. *

Check all that apply to this pets personality *

Bad Habits *

Afraid of *

Thunder Men Women Strangers Children Noises Dogs Cats

Knows How To *

Is the dog used to a fenced in yard *

Yes No Unknown

Walks on leash... *

Fine Pulls Never Walked on Leash Learning

Please upload at least one picture. *

Additional picture (optional)

IF YOU PLAN TO HAVE YOUR ANIMAL ATTEND OUR ADOPTION DAYS, PLEASE READ THE FOLLOWING AND PROVIDE YOUR SIGNATURE AND DRIVERS LICENSE NUMBER AS AGREEMENT.

I as Guardian of the above-described animal do hereby release the Animal to Capital Area Animal Welfare Society (“CAAWS”) for adoption purposes only. Upon the animal’s adoption, I expressly release and transfer possession and ownership to the Adopter and relinquish all rights and claims to the Animal. I also certify that the Animal has never bitten a person or other animal to my knowledge.

I hereby release and hold harmless CAAWS, as well as any individual member thereof, from all claims I have on this date or may have in the future pertaining to the Animal. I further agree to indemnify and hold CAAWS, as well as any individual member thereof, free and harmless from any loss, damage, injury, or other casualty to any person, animal, or property caused by the Animal or in any way related to this transaction.

I understand that CAAWS has specific adoption criteria, that CAAAWS reserves the right to deny the adoption application of any individual, and that CAAWS is under no obligation to adopt this Animal to any person that does not fit the criteria or is found to be unsuitable in any way.

I acknowledge and understand that I am responsible for the removal of the Animal from the CAAWS adoption facility if the Animal is not adopted. I further acknowledge and understand that I must remove the Animal by 2:50p.m. on the date of this Agreement and on any future dates that the Animal is made available for adoption at the CAAWS adoptions facility. FAILURE TO DO SO MAY CONSTITUTE ABANDONMENT.

To assure that I will return to remove the Animal, I am leaving a deposit in the amount of $50 per animal. I understand that my refundable deposit will be returned when I return to remove the Animal. If the Animal is not retreived, I (1) forfeit my deposit, and (2) release the Animal to CAAWS to do with as CAAWS deems necessary, including but not limited to medication and/or euthanasia (putting to death).

I hereby certify that I have read and understand all the terms and conditions stated in the above paragraphs. *

Please provide your DL number if you plan to attend in person

I, the applicant for public assistance in rehoming a dog, warrant the truthfulness of the information provided in this application.

Electronic Signature *

First Name Last Name

I understand that submitting this form constitutes a legal signature confirming that I acknowledge and agree to the above Terms of Acceptance.

Public Assistance Adoptions