Document Sample
Dated Powered By Docstoc
Names of applicants: ______________________________________________________ Address: ________________________________________________________________ City: ____________________________________ State: ___________ Zip: ___________ Home Phone: __________________________ Cell Phone: ________________________ E-mail: _______________________________ Drivers Lic: _________________________ Employer:_____________________________ Hours of Work ______________________

QUESTIONNAIRE: Pet(s) you are interested in adopting: __________________________________________ What makes you want to adopt a pet at this time? ________________________________ If a purebred, have you researched on specific breed? ____________________________ Who lives in your household? List names and ages of people: ______________________ ________________________________________________________________________ Are all family members in agreement in adopting pet? _____________________________ Do you live in an Apartment / Condo _____, Townhouse _____, House _____, Other ____ Do you rent or own ? __________ If "Rent", does landlord approve of pets? ___________ Landlord phone # _____________ Weight limit? _______ Breed restrictions? ______ If restrictions, please explain, _____________________________________________ Please tell us about the pets you currently have, and if male or female: _______________ ________________________________________________________________________ Do you have a secured yard and fence/wall? ____________ If YES how tall? __________ Is the gate locked? ____________ Do you have a pool? ___________ Is it fenced? ___________ Where will the pet sleep? ___________________________________________________ Will the pet be living indoors or outdoors or both? ________________________________ Where will the pet be during the heat of the day? ________________________________

Do you currently have a "pet" door? __________________________________________ How many hours per day will the pet be left alone? ______________________________ Have you previously owned and cared for a pet(s)? ______________________________ Have you ever given up a pet to a shelter? _____ If YES, for what reason? ___________ ________________________________________________________________________ Have you ever been to an obedience training class?_____If YES where? ______________ Are you willing to take a class for undesirable behavior if needed? ____________________ Will you commit your home to this pet for their lifetime, despite changes in your life, such as moving, having a baby or getting divorced? ______________________________ Will you agree to contact this rescue should any problems arise and not under any circumstance turn this pet into a shelter (We always want our Pets back with us) ________ Please list your Veterinarian's name:______________________ Telephone: ____________

PLEASE LIST TWO PERSONAL REFERENCES: Reference #1 Name: _______________________________________________________ Relationship: ___________________________ Phone: ___________________________ Reference #2 Name: _______________________________________________________ Relationship: ___________________________ Phone: ___________________________

**Please initial the following below after reading each statement I UNDERSTAND that Paws & Claws Pet Fostering has done its best to assess the pet’s temperament and health, but cannot guarantee that the pet will not develop behavior or health problems in the future. [ ] Initial I AGREE NOT TO HOLD Paws & Claws Pet Fostering liable for any damage to persons or property. [ ] Initial I AGREE to keep an I.D. tag on the pet’s collar at all times. If I move, I will update the tag and microchip’s information. [ ] Initial I UNDERSTAND that by adopting this pet, I am agreeing to provide a permanent home for the pet’s lifetime. I also agree to maintain appropriate and necessary healthcare in the form of vet visits. [ ] Initial I AGREE that if I am unable to provide a permanent home or provide care for the pet that I will contact Paws & Claws Pet Fostering immediately. [ ] Initial I AGREE that a representative of Paws & Claws Pet Fostering may perform a home check prior to adoption. [ ] Initial

I AGREE the adoption fee is non-refundable. [

] Initial

I UNDERSTAND that if I must give up the pet, I will contact Paws & Claws Pet Fostering and make arrangements to return said pet directly to us. I agree that I may not take the pet to a shelter or “give” the pet or adopt the pet to anyone that has not been preapproved by Paws & Claws Pet Fostering [ ] Initial

I acknowledge that all of the information contained in this form is true and correct to the best of my knowledge. I understand that any misrepresentations of fact may result in the removal of the adopted dog from my home by Paws & Claws Pet Fostering. [ ] Initial

Adopter’s Signatures: (1) ___________________________________________________ Date ____________ (2) ___________________________________________________ Date ____________

THANK YOU FOR ANSWERING ALL OUR QUESTIONS TO ENSURE THE SAFETY OF OUR PETS! If you have further questions, please call Nancy @ 623-330-6254

Shared By: