Name
*
First Name
Last Name
Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Email Address
*
Phone Number
*
Are you interested in a specific dog? If so, which one?
Applicant's Age
*
Please Select The Appopriate Age Category
Under 18
Age 18 to 25
Age 26 to 40
Age 41 to 65
Over 66
Veterinarian's Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Personal Reference #1, Relationship To You
*
Personal Reference #1, Phone Number
*
(###)
###
####
Personal Reference #1, Email
*
Personal Reference #2, Relationship To You
*
Personal Reference #2, Phone Number
*
(###)
###
####
Personal Reference #2, Email
*
Why are you interested in adopting?
*
Please tell us about your household, and what made you interested in adopting a dog!
How many hours a day will the dog be left alone?
*
Where will the dog be kept when alone?
*
Please be specific (I.E. crate, room, run of the house, etc.)
What kind of food will you feed your dog and what is your feeding plan?
*
How do you plan to housebreak the dog or allow it to eliminate if it is not already housebroken?
*
Do you have a yard that is fenced securely enough to contain a dog?
*
If not, how will you exercise and/or allow the dog to eliminate outdoors?
Please provide details of your animal(s)
Such as type of animal, name, breed, sex, age, etc.
Are your pets up to date on shots and heartworm prevention?
Yes
No
If you selected no above, please explain why they are not
Are your pets spayed or neutered?
Yes
No
If you selected no above, please explain why they are not
Have you owned animals in the past, not listed above?
*
Yes
No
If yes, please tell us why they are no longer with you:
*
Ran Away
Stolen
Sold
Lost
Given Away
Surrendered to shelter/rescue group
Euthanized
Died
Please provide details regarding the above that you feel is important to your application
Have you ever been charged / convicted of animal cruelty under any municipal, provincial/state or federal regulations or laws?
*
Yes
No
Do you have any experience with rescued animals? If so, please explain
*
Rescue dogs will go through a period of adjustment when entering their new forever home. For example, they may become extremely shy, somewhat aggressive or display other negative behaviour. They may also start ‘doing their business’ inside the house or may not eat at their regular meal times. Tell us how you plan to work with your new dog to ensure this adjustment is smooth and as trouble free as possible?
*
Are there any children in your household?
*
Yes
No
If yes, how many children are there and what are their ages?
If you have children in the household, how much of the responsibility will your child be given for the care and management of the dog?
Maximum
Some
Minimal
None
How much adult supervision will be provided when the dog and child are together?
Maximum
Some
Minimal
None
Please list the names and ages of all co-habitants or others who frequently share your premises and/or fenced yard
*
Please select which residence is applicable to you
*
I own a single family home
I own an apartment or condo
I own a townhouse or garden home
I own a farm
I own a mobile home
I rent a single family home
I rent an apartment or condo
I rent a townhouse or garden home
I rent a farm
I rent a mobile home
Other
Are you willing to permit a home check?
*
Yes
No
Nothing in this adoption application or application process shall constitute or seek to establish a legal relationship between applicant and Paws Above. Paws Above Rescue reserves the right to deny an applicant on any grounds and/or withdraw from the application process at any time without penalty or claim. Any and all decisions in the application and adoption process shall be made by Paws Above Rescue in its sole discretion.