First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

Email*

Home Phone

Work Phone
x

Cell Phone

Alt Email

Text/Pager Email

Which animal are you interested in
Choose an animal: Sammie

If you wish to apply for more than one animal, please fill in the names of who you'd like to apply for. Give a rank order for preferences or state both if applying for a pair.

What is your date of birth?*

Place of employment, how long have you worked there, and phone number*

Driver's License #, State, DOB, and expiration

What is the full name of your partner, spouse, or companion?

What is your partner's date of birth?

Spouse/ Partner employment, how long have they been employed there, and phone number

Do you own or rent your home*
Choose one: Rent Own

In what type of home do you live*
Choose one: Single Family Duplex Apartment Townhouse Condominium Mobile Home Military Housing

What is the approximate size of your living area (i.e. # of sq feet)

Is there a restriction on the # of pets or type of pets you are allowed where you live?*
Choose one: Yes No Not applicable

If yes, what are they?

If you rent, please enter your landlord's name, phone number, and if applicable, name of Community to verify pet security/deposit has been paid and number of pets allowed

If you rent, have you received the approval of your landlord to have an animal
Choose one: Yes No

Are you anticipating a move, pregnancy, marriage, new home, or any other major change anytime in the next few months? Explain*

How many people reside in your household*

Ages of children living in the household, and are they temporary or permanent resident(s).

Does anyone living in your household have any kind of medical condition…allergies, suppressed immune system, diabetes, or taking blood thinners?*
Choose one: Yes No

If you answered yes to the previous question, what is the condition?

Where will the litter box be kept?*

Who in the household will care for the pet*

Where will the animal be kept when you are not home*

How much time will the animal spend alone, without human companionship, per day?*

Will the animal be kept inside or outside*
Choose one: Inside Only Outside Only Inside and Outside

When do you plan to declaw*
Choose one: Never Immediately 4-6 months 1 year Maybe

Have you ever owned a cat before? If so, how long ago?*

How many pets do you currently have?

Are ALL your other pets up to date on their vaccines?*
Choose one: Yes No Not applicable

Are ALL your current pets spayed or neutered?*
Choose one: Yes No Not applicable

Are any of your other cats declawed?*
Choose one: Yes No Not applicable

Current pet 1 name, age, species, and breed

Current pet 2 name, age, species, and breed

Current pet 3 name, age, species, and breed

Current pet 4 name, age, species, and breed

Current pet 5 name, age, species, and breed

If any cats are listed above, are any of them overweight or on a special weight diet (if yes, please explain):

What type of food do you feed?*
Choose one: dry wet wet & dry raw n/a

What brand(s) of food do you feed, what formula, and is/are they wet or dry food? If not applicable, type n/a*

If you have in the last five years owned any other pets that are no longer with you, what was their name, age, species, and reason they are no longer part of your household?

Veterinarian's Name and Phone Number. If not applicable, write n/a.*

I attest that the information provided above is correct. I understand that this is only an application for adoption and does not constitute a contract or guarantee me to receive the pet applied for. PAWS has the right to refuse an adoption to any individual on any grounds. I give PAWS permission to verify the information provided on this sheet. Also, I agree to provide my Driver's License Information at time of adoption if I am approved. I also understand PAWS will not pay any vet bills. No refunds after 72 hours.*
Choose one: Yes No

Please electronically sign your application*

Please enter today's date.*