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Dog Adoption

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					             P O BOX 903                           PAWS
             Goose Creek SC 29445
             (843) 207-PAWS
                                            ADOPTION APPLICATION
                                                                                                           Dog’s Name

Please read the terms of PAWS ADOPTION CONTRACT before completing this form.
By completing this form you indicate that you have read and agree to the terms of the PAWS ADOPTION CONTRACT.
Answer all of the questions; do not leave any blank.


Name_______________________________________________________Age _______
Street address____________________________________________________________________________________
City__________________________________________ State_________ Zip______________________
Phone (H)________________(W)_______________ (CELL)______________ Drivers License#____________________
You must be eighteen years of age and have the consent of all adults living in your home to adopt a pet.
Do you own your own home?         YES     NO       Live with parents?      YES      NO     Attend school?      YES     NO
* If you rent, include a copy of your lease agreement with this application.       *REQUIRED*
* Property Owner's name ________________________________________________* Phone_____________________
* Employer's name _____________________________________________________* Phone _____________________
* Personal reference____________________________________________________* Phone _____________________
* Veterinary reference___________________________________________________* Phone _____________________
Dogs can live for 15 to 20 years. When you adopt this dog you are agreeing to keep it and care for it for it's entire life.
Number of people in the household: _________ adults           ________ children _________ ages of children ____________
PAWS does not recommend the adoption of dogs to homes with children under the age of 5.
Is anyone in the household pregnant?       YES    NO             Does anyone in the household have allergies? YES NO
Do you have a fenced-in yard?      YES     NO      Height of fence____________           Chain link   or   Wood
Where will this dog stay most of the time?       Inside      Outside      Kennel         Doghouse      Crate
Do you have other pets? How many? Dogs ____ Cats ____ Vaccinations YES                     NO Spayed/Neutered? YES          NO
Does your dog stay      INSIDE     OUTSIDE       BOTH        Does your cat stay    INSIDE     OUTSIDE       BOTH
Have you had other pets? YES NO What happened to them?______________________________________________
Have you ever turned in a pet to a shelter?      YES NO Why?___________________________________When?_______
Are you willing to observe your pets for two weeks or longer before leaving them alone together? YES              NO
Why do you want to adopt this pet?_____________________________________________________________________ Are
you familiar with the needs of a dog? YES         NO      Will you keep this dog's vaccinations current?    YES      NO
Do you understand that this dog may take several days, weeks, or even months to adjust to your household? YES               NO
If you are adopting a puppy, is someone home to housetrain it?          YES    NO
How will you prevent behavioral problems?______________________________________________________________
Barking?_____________________________________________Digging?_____________________________________
Chewing?_________________________________________Fence Jumping?__________________________________
Number of hours this pet will be alone?_______________ If you must move, will you take this pet with you? YES               NO


I certify that the information I have given is true and I understand that any misrepresentation of facts may result in losing the
privilege of adopting a pet or in the immediate reclamation of an adopted pet. I understand that this application may be denied. I
authorize investigation of all statements in this application.


Signature _________________________________________________Date___________________
11/13/03

				
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