Little Paws Adoption Application


Which of our dogs are you interested in?

BASIC INFORMATION

Name:
Email:
Address:
City:
State:
Zip:
Phone:

What is your occupation?
Where are you employed?
How long at present job?

ENVIRONMENT

What type of housing do you have?
How long have you lived at this location?
Do you own this residence?
May we visit your home?
May we contact your landlord?
Please provide landlord name and contact information:

Do you have a fenced yard?
How many children are in home?
Please list their ages:
Please list any other people in home:

Where would the dog spend its daytime hours?
How many hours per day would the dog be left alone?
How would you use to secure the dog while you are away?
Where would the dog spend its nights?
How do you feel about tethering/chaining a dog?

Do you own a kennel crate?
How do you feel about crating a dog?
How do you feel about keeping a dog outside in cold weather?
What types of dog food do you use?

PETS

Why do you want a dog?
Have you ever sold a dog?
Given a dog away?
Surrendered a dog to an animal shelter?
If yes to any of the above questions, please explain:
Were there any problems with your last dog?
What happened to it?

Please list all pets that you have now:
     Type:      Breed:             Age:       Sex:      Altered?
Ex. Dog      Hound Mix     3 years       F          Yes
1)  
2)  
3)   
4)   
5)  
6)   

Are dogs in your household current on vaccinations?
Are your dogs (or were past dogs) on monthly heartworm preventative?
Please list the brand:

REFERENCES

Please list the name and phone number of your veterinary clinic?
Do we have your permission to contact them?
Do you have someone whom we may contact as a reference?

COMMENTS

If you have additional information or comments, please express here:


Please acknowledge by typing your name and the date of this application that you have been forthright with answers to the above questions:

Thank you!
Please send your completed application when ready!