This page was last updated: November 25, 2009

All right reserved P&P 2009

To fill out the form below, please highlight, copy, click on the proper icon picture above, paste, and fill out the form. You may also use these icons to send us an email with any questions you may have. You may delete an answer such as yes or no leaving the answer you want. Please note: after you have submitted your application, we will contact you if your application has been accepted for consideration.

                                                             Adoption Application

What type of pet are you applying for? Dog Cat Small Animal

What type of small animal?____________ Male Female Age:____ Name of animal: ____________ ID#____________

Applicant Name: __________________________________ Phone #: ________________Cell ____________________

Applicant Address: ___________________________________City/State: ________________Zip Code___________

Email Address: ____________________________________________________

Do you rent or own your residence? Rent Own   If you rent, does your landlord allow pets?   Yes  No

Name of Landlord: ____________________Phone # ______________

                                         (Rental agreement must specify that you may have pets)

How many adults in household: ________ How many children in household: _____ Ages ____________________

Applicant(s) work schedule:_________________________________________________________________________________

Does any member of the household/family have allergies? Yes No What type of allergies?_ _________________

Current or Past Pets

Name ___________________ Age ____ Breed ____________ Vaccinated? Yes No Spay/Neuter? Yes No

Do you still own? Yes No If no, what happened to your pet?_____________________________________________

Name ___________________ Age ____ Breed ____________ Vaccinated? Yes No Spay/Neuter? Yes No

Do you still own? Yes No If no, what happened to your pet?_____________________________________________

Applying for a Cat or Kitten

Where will your cat be when you are not at home? Inside Outside

Has your current cat/kitten been combo tested for FIV/FeLV? Yes No

Is your current cat declawed?  Yes No    Are you planning to declaw your new cat?    Yes  No

Where will your cat sleep? ________________________ How many hours will your cat be left alone?_____________

Applying for a Dog or Puppy

Are you willing to crate train? Yes No Are you willing to obedience train? Yes No

Where will your dog sleep? Inside Outside How many hours will your dog be left alone? ________________________

How will you exercise your dog? _________________________________________________________

Do you have a completely fenced yard? Yes No

Veterinarian Information:

Current Veterinarian: _________________________________________ Phone #: ____________________________

Names of pets registered there: __________________________________________________________________________

Have your pets been seen by another Veterinarian? Yes No If so,what office?_________________________________

Just one last question: How did you find out about us? Petfinder, Craig's List, web site, recommendation?

I hereby certify that I am at least twenty one years of age, and to the best of my knowledge, the information that I’ve provided above is true. I will contact my veterinary hospital to release any and all records to an agent of Paws and Purrs Animal Rescue, Inc. I understand any false information may result in the nullification of this application.

Signature: ______________________________________________________       Date:_______________________

Office use:

Vet check Yes No Proof of age: Yes No Application approved? Yes No

Reason for denial_ _______________________________________________________________________________________

Vet check performed by: ________________________________________________________

Date: ______________________

An animal's eyes have the power to speak a great language.

                                 - Martin Buber