Pawsitively Furever Adoption Form

Full Name*

First NameLast Name

Age

E-mail*

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number - Home

Area CodePhone Number

Phone Number - Cellular

Area CodePhone Number

Phone Number - Work

Area CodePhone Number

Do you live in a:

Do you:

OwnRentLive with Parents

If Renting: Please indicate landlord contact information

Household Setting

RuralSuburbanUrban

Describe your Homes Activity Level

Busy/NoisyModerate Comings/GoingsQuiet with Occasional Guests

Please List all People Living in the Household (Include Name, Relationship, Gender and Age)*

Does Anyone in your Household have Allergies to Animals?

YesNo

Are all members of your Family agreeable to Adopting a Dog?

YesNo

Please List any Pets you have Living or Deceased (Please include Name, Breed, Age, Sex, UTD Vaccines, Heartworm, Living/Deceased)*

Are you willing to give your adoptive dog 3-4 weeks to adjust to their new environment?

YesNo

Do you have a relationship with a Veterinarian?

YesNo

Vet Reference: Full Name*

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number

Area CodePhone Number

Are you prepared for the medical expenses that can come with owning dogs? How much are you preparing to spend annually on vet work?

We cannot guarantee a dog to be housebroken, are you equipped to train with love and patience?

YesNo

Have you had any experience with with an emotionally or physically neglected or abused dog?

YesNo

If Yes please explain

Do you have a fenced yard?

YesNoPartial

If fenced, please give details on height, material, number of gates, are gates locked or lockable?

Please describe where the dog will sleep.

What type of training methods will you use with your dog? Will you be going to a trainer?

How many hours in a day would the dog be left alone?

What are you plans to exercise your dog? Please list any parks near by or trails, how many walks a day, approximate length, and activities such as agility.

Please list 3 personal references with names, addresses, phone numbers and how related. We prefer it not to be all relatives. Are you ok with this?

YesNo

Reference #1: Full Name*

First NameLast Name

Relation to applicant(s):

E-mail

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number

Area CodePhone Number

Reference #2: Full Name*

First NameLast Name

Relation to applicant(s):

E-mail

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number

Area CodePhone Number

Reference #3: Full Name

First NameLast Name

Relation to applicant(s):

E-mail

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number

Area CodePhone Number

Which PF Dog are you interested in?

What are you looking for in an adoptive dog? EI Sex, Size, Temperament, Energy Levels, ETC

Rescue Dogs come with a variety of potential behavioral issues. Is there any issues you are not willing to work through?

What will you do if you can no longer care for your dog?

By sending this electronically, I acknowledge that I have completely read this application and comprehend it fully.

I understand that applying does not ensure approval and that untruthful answers or failure to comply with the requirements of this application can result in the forfeiture of any Pawsitively Furever Animals being adopted by me.

I certify that the above information is correct, and I understand that the information will be verified.

I understand that by submitting this form electronically, I agree to release and covenant to hold harmless Pawsitively Furever and it's members from any claims, damages, costs, or actions incurred because of the care or actions of the adoptive dog.

I accept full responsibility for the dog(s) actions at all times, and release Pawsitively Furever from any liabilities or damages that may be incurred because of adopting such dog(s).

I agree to have Pawsitively Furever complete reference call checks and conduct a home visit inspection to be able to approve my adoptive application.

Date

MonthDayYear

Phone Number

Area CodePhone Number

Your name*

E-mail