P.A.W.S

P.O. Box 2184

Riverview, MI 48193

Info@pawsofmichigan.com

____________________________________________________________

 

 Dog ADOPTION APPLICATION

Date: 

 

Interested in (circle one): 

Dog        Puppy               Animal’s Name 2nd choice

 

Age of applicant:   Age of co-applicant: Do live you  with your parents?

 

Name: Address:

 

City, State, Zip

 

Home phone: Cell # E-Mail

 

How long have you lived at present address?

     Do you live in a:  House    Apartment     Condo    Mobile Home  

 

If renting, Landlord's name and phone number:

 

What is your reason for wanting to adopt an animal?

  Are you adopting for:   Yourself   family   others   gift/surprise

 

Are you looking for an:  House Pet    Guard Dog   Watch Dog   Companion and Play Pal for Current Dog   

Backyard Pet   Gift  Child's Pet   Breeder   Other

 

How many adults reside in your home? , children & ages ,,,,,

 

Are all household members in agreement with adopting this Dog?

 

Does any members of the household have any allergies?, If so, describe

 

Who will be responsible for taking care of the dog?

 

Do you presently have any pets? If yes list breed(s), age(s), sex and name(s):

 

Breed Age Sex Spayed /
Neutered
Vaccines
Current
Heartworm
prevention dogs
Name

yes

yes yes
yes yes yes
yes yes yes
yes yes yes
yes yes yes
yes yes yes

  

 

Who is your current/previous veterinarian? (clinic name & phone #)

 

What other pets did you have in the last ten years?

 

How long did you have them?

  Where are they now?

 

How much time do your current/previous pets spend outside?

 

How much time would this new pet spend outdoors?

 

How many hours per day will this animal be left alone?

 

Where will the pet be kept when left alone?

 

Does your yard have a fence?

 

If so what is the Height of your fence?

 

If not what are your plans to keep the dog confined to your yard?

 

The average cost per year for providing preventive veterinary care is $300-350. 

Additionally there are expenses of food, toys, grooming, boarding, emergency vet care, etc. to consider,

does your household budget allow you to comfortably cover these expenses?Yes No

 

Rescue animals require time to adjust to their new home.  What amount of time do you consider to be reasonable for adjustment?

 

What behaviors would you be unable to tolerate from an adopted Dog/Puppy? (check all that apply)  

    

Excessive Barking

Unfriendly toward other pets

Shy, Skittish, or Hides alot

Chewing

Digging

Getting on furniture

Getting into Garbage

Shedding Hair on Furniture/Clothes

Escaping

Fighting 

  

 

 

Methods I plan to use to discourage unwanted behavior(s) (check all that apply)

 

Remove problem item

Distract Him / Her and reward good behavior

Yell

Put dog in other room

Put dog outside

I won't tolerate bad behavior

Swat/spank/hit with newspaper

Spritz with water

Throw something at dog

Other

Dog Obedience Classes

 

 

 

 

 

 

select all of the following that may cause you to give up your Dog/Puppy? (check all that apply)  

    

Birth of a child

New roommate

Marriage

Divorce

Need regular medication

Unemployment

Allergies

Other

 

 

The foregoing information that I have provided to P.A.W.S for the purpose of adopting an animal is accurate and complete.

By Typing Your Name you agree to The above

 

SIGNED:

 

     DATE: