Applicant's Information
Name of the dog you are considering:
Date:
Your Name:
Address:
City:
Home Telephone:
Zip Code:
Work Telephone:
Cellular:
Occupation:
Email Address:
Are you a full-time Florida resident or a seasonal resident?
Full-Time Seasonal
Pre-Adoption Questions
Have you ever owned a dog/cat?
No
Yes - Dog
Yes - Cat
Yes - Both
Are you adopting this pet for you or someone else?
Myself
Someone Else
What member of the family will be taking the MAJOR responsibility for caring for this pet?
List the name(s)/age(s) of the members of your household:
Are you financially able and willing to provide annual check-ups, vaccinations and any medical care necessary if your pet becomes sick or injured?
Yes No
Is anyone home during the day?
Yes No
If so, who?
If you are not home during the day, have you considered adopting two similar pets to keep each other company?
Yes No
Where do you plan on keeping your pet while you are at work or not at home:
Do you or anyone in your household have allergies or asthma?
Allergies
Asthma
Both
No
Type of housing:
Name of development:
Does your association permit pets?
Yes No
Is there a weight limit?
Yes
No
Is there a deposit required?
Yes No
If yes, how much?
Own or Rent?
Own Rent
If you rent, do you have permission to have pets?
Yes No
If necessary, may we contact your landlord?
Yes No
Please provide name and telephone number:
Do you have a fenced-in yard?
Yes No
Do you have a pool?
Yes No
Do you have a balcony?
Yes No
Do you have a screened patio?
Yes No
If apartment/condo, what floor do you live on?
Please describe those pets that are currently living with you including their name:
# of dogs:
Breed(s)/Age(s):
Neutered/Spayed?
Yes No
Vaccinated?
Yes No
# of cats:
Breed(s)/Age(s):
Neutered/Spayed?
Yes No
Vaccinated?
Yes No
Please describe those pets that formerly lived with you including their name: (Going back at least 5 years)
# of dogs:
Breed(s)/Age(s):
Neutered/Spayed?
Yes No
Vaccinated?
Yes No
Why are they no longer with you and if they passed away, what was the cause?
# of cats:
Breed(s)/Age(s):
Neutered/Spayed?
Yes No
Vaccinated?
Yes No
Why are they no longer with you and if they passed away, what was the cause?
Where did you get your last pet?
Have you ever turned in an animal to an animal shelter?
Yes No
If yes, why?
Have you ever put a dog/cat to sleep for any reason?
Yes No
If yes, why?
Where do your current animals live:
Name of your current or past Veterinarian?
Telephone Number of your current or past Veterinarian?
What will you do if your new pet doesn't get along with your current pet or pets?
How long will you give your new pet to adjust to its new home?
If your family status changed (new baby, married, divorced, job loss, relocation, etc.), who would keep the dog/cat?
If something happens to you and you cannot take care of your pet(s), who will take care of the animals?
If you move, what will you do with your pet(s)?
When you go on vacation, where will your pet(s) go and who will care for them?
What do you think are the most important responsibilities in owning a pet?
References
Please supply the name, address and telephone numbers of two (2) personal references:
Name:
Telephone Number:
Address:
City:
State:
Zip:
Name:
Telephone Number:
Address:
City:
State:
Zip:
How did you hear about us?
I certify that the information I have given above is true and correct, and I hereby authorize the above listed Veterinarian(s) to supply information in regard to my pets to Paws 4 You Rescue, Inc. I also give my permission to Paws 4 You Rescue, Inc. to contact the above listed landlord and references.
I understand that Paws 4 You Rescue, Inc. has the right to deny any application without any questions and Paws 4 You Rescue, Inc. has the right to take back an adopted pet if they find that the home is inadequate.