Adoption Questionnaire

Tell us know how you learned about PAWS

search engine/website Facebook Vet Friend Petfinder Adopt a Pet

To be considered for a PAWS adoption you must:

Be 18 years of age

Have the knowledge and consent of all adults living in your household

Have verifiable identification

Understand that PAWS has the right to deny your application

Name(s) of Pet(s) you are interested in adopting

This pet is a

Dog Cat

To insure that the cat or dog you want to adopt will be best suited for you, your home, and lifestyle, please provide us with the follwoing information

Full Name *

First Name Last Name

Spouse's Name *

First Name Last Name

Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

E-mail *

Your Phone Number *

Area Code Phone Number

Spouse's Phone Number

Area Code Phone Number

Your place of employment? *

Work Phone # *

Spouse's place of employment *

Work Phone # *

Residence *

House, own House, rent Apartment or Condo Mobile home Live with parents Dorm or other on-campus housing

Landlord will be called to verify the lease allows pets

How long have you lived at above residence?

How long to you plan to stay at this residence?

What is your landlord's name & phone #

If you do move in the future, what are your plans for your animals?

List all other people living in your home.

Name

Age

1.

2.

3.

4.

5.

Is anyone in your home allergic to cats or dogs?

Yes No

Have you ever given a pet away before, to anyone, for any reason? If so, please tell us about that experience.

Describe your perfect pet

Describe your experience with this type or breed of pet

This pet needs to get along with: *

Dogs Cats Kids under 5 Kids over 5 Just me Men Women Other animals not listed

I prefer a pet with an activity level that is:

Low Medium High No Preference

Do you understand that it may take your new pet anywhere from 2 weeks to a couple months to adjust to his/her new environment and for his/her true personality to emerge?

Yes No

Cat/dogs can live longer than 15 years. Are you ready to take responsibility for your new pet's enire life?

Yes No

Which member of the household will hold primary responsibility for overseeing the feeding of this pet

Which member of the household will hold primary responsibility for overseeing the training of this pet

Which member of the household will hold primary responsibility for overseeing the general care of this pet

How will you exercise your pet?

What concerns, if any, do you have about adopting a new pet?

Describe any behaviors this pet could have that would be totally unacceptable to you

Will your pet spend any time outside (dogs only)? How much?

This pet will be alone (without human companionship) for how many hours per day

When pet is left alone, where will he/she be kept?

At night, where will your pet sleep?

CAT - how will you train your cat to not scratch on furniture

CAT - how will you train your cat to not chew on plants

DOG - Do you have a fenced yard (not required)

Yes No

Name of your veterinarian: *

Phone number of your veterinarian: *

Area Code Phone Number

Will you be using this vet for your new adopted pet?

Yes No

If no, name & phone of veterinarian

Please tell us about the animals you have now.

Name

Species

Male or Female?

Spayed/Neutered/Vaccinated?

Age

Notes:

1.

2.

3.

4.

5.

6.

If your existing cats or dogs are not spayed or neutered, please tell us why:

Tell us about the animals you have had in the past 5 years, that you no longer own.

Name

Species

Spayed/Neutered/Vaccinated?

Length of Ownership

Died/Rehomed/Lost

1.

2.

3.

4.

5.

PLEASE READ I have read the above information carefully and have fulled out this application honestly. I understand that omission of information and/or failure to answer all questions and sign the application can result in this application being declined. Also, if an omission or untruth is discovered after an adoption takes place, I understand that PAWS Protective Animal Welfare Society of Western WI reserves the right to annul the adoption and reclaim the animal. I give PAWS Protective Animal Welfare Society of Western WI permission to investigate the information provided, as well as contact veterianarians and related officials. I understand the adoption decision is dependent on many factors, inclucing but not limited to the compatibility of the family and home to the individual pet, and other applications received on this pet. I understand it is PAWS Protective Animal Welfare Society of Western WI sole prerogative to decide which home is most appropriate, that my application can be denied at any time for any reason, that their decision is final, and I will not contest it. It is our goal to place pets in loving, lifelong homes and any information gathered is used only to that interest. I have read and agree with this statement. My typed name will serve as my signature.

Type name for signature

Date

Adoption Application