PAAW

                 Apply to Adopt a Pet from PAAW Warren!

**Be sure to click SUBMIT at the very end of the application**

Today's Date
Dog or Cat?
Animal Name
Name:
Email Address:
Phone number(s)
Address
City
State and zip code
Are you over 21 years of age? Yes
No
Have you ever owned a pet? Yes
No
If this is your first pet, (not including childhood pets) please supply us with 3 personal references.
Do you currently live in a....? House
Apartment
Townhome
Condo
Mobile Home
Do you....? Own
Rent
Does your association or landlord allow pets? Yes
No

How many people currently live in your household?

Adults
Children
Please list the ages of the children in the house.
Check the reason you plan on adopting Family Companion
Companion for existing pet
Other
Does anyone in the house have any allergies? If yes, please explain.
Are you aware that the cost of vet care is at least $100-$200 per year, without serious illness? Yes
No
How many pets have you owned in the last 10 years?
What happened to the animals no longer in your home? (ex. passed away, ran away, gave to someone else)
Please supply the following information of all the animals currently living in your home: 1. Name, 2. Type, 3. Age, 4. Sterilized?(Y/N) 5. Current On Vaccines?(Y/N) 6. Declawed?(Y/N) 7. Heartworm Preventative?(Y/N)8. Reside-Inside or Outside?
Have your animals ever been exposed to other animals?
Name of current or prior veterinarian (Name, Location and Phone #) (Vet information will be verified)
Are any of your pets being treated for medical conditions? Explain.
Where will this animal be living? Inside
Outside
Do you have a fenced yard ? If so is the fence a chain link, privacy fence, invisible fence, or kennel?
Approximately how many hours would the animal be left alone during a given day?
Would you object to someone from the rescue coming/calling your home to check on the animal? Yes
No
Please list three references, with Phone number and relationship to you.
I understand completion of this evaluation does not guarantee the adoption of this pet. Furthermore, falsification of information will result in immediate denial of this application. Incomplete evaluation will not be processed. Yes

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