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Applicant's Information
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| Name of the dog you are considering: |
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Date: |
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| Your Name: |
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| Address: |
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City: |
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| Home Telephone: |
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Zip Code: |
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| Work Telephone: |
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Cellular: |
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| Occupation: |
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Email Address: |
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| Are you a full-time Florida resident? |
Yes No |
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| 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? |
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| List the name(s)/age(s) of the members of your household: |
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| 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 |
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| Is anyone home during the day? |
Yes No |
If so, who? |
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| If you are not home during the day, have you considered adopting two similar pets to keep each other company? |
Yes No |
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| Where do you plan on keeping your pet while you are at work or not at home: |
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Do you or anyone in your household have allergies or asthma? |
Allergies
Asthma
Both
No |
| Type of housing: |
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Name of development: |
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| 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? |
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| 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: |
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| 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? |
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| Please describe those pets that are currently living with you including their name: |
| # of dogs: |
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Breed(s)/Age(s): |
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| Neutered/Spayed? |
Yes No |
Vaccinated? |
Yes No |
| # of cats: |
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Breed(s)/Age(s): |
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| 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: |
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Breed(s)/Age(s): |
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| Neutered/Spayed? |
Yes No |
Vaccinated? |
Yes No |
| Why are they no longer with you and if they passed away, what was the cause? |
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| # of cats: |
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Breed(s)/Age(s): |
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| Neutered/Spayed? |
Yes No |
Vaccinated? |
Yes No |
| Why are they no longer with you and if they passed away, what was the cause? |
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| Where did you get your last pet? |
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| Have you ever turned in an animal to an animal shelter? |
Yes No |
If yes, why? |
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| Have you ever put a dog/cat to sleep for any reason? |
Yes No |
If yes, why? |
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| Where do your current animals live: |
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| Name of your current or past Veterinarian? |
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Telephone Number of your current or past Veterinarian? |
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| What will you do if your new pet doesn't get along with your current pet or pets? |
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| How long will you give your new pet to adjust to its new home? |
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| If your family status changed (new baby, married, divorced, job loss, etc.), who would keep the dog/cat? |
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| If something happens to you and you cannot take care of your pet(s), who will care for the animals? |
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| If you move, what will you do with your pet(s)? |
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| When you go on vacation, where will your pet(s) go and who will care for them? |
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| What do you think are the most important responsibilities in owning a pet? |
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| References |
| Please supply the name, address and telephone numbers of two (2) personal references: |
| Name: |
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Telephone Number: |
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| Address: |
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City: |
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| State: |
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Zip: |
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| Name: |
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Telephone Number: |
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| Address: |
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City: |
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| State: |
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Zip: |
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How did you hear about us?
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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.
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