First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
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County*

Email*

Home Phone*

Work Phone
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Cell Phone

Alt Email

Co-Applicant's Name

For which dog are you applying?*
Choose an animal: Butchey Lillian Penny UNLISTED DOG

Please list the names of all adults in the household, along with their relationship to the applicant. Include yourself, and any applicable co-applicant(s). By completing this form, you are confirming that both the applicant and co-applicant are at least 23 years old.*

Please list the ages of children currently living in your household.*

Is anyone in the household a "stay-at-home" person? Please explain.*

Tell us about your past & current animals. Include breed, age, and health status.*

Are your current pets spayed/neutered? Are they up to date on all vetting and vaccinations? If not, explain why not.*

Has anyone in your household been convicted of a crime involving domestic battery, animal cruelty, or other violent crime? If yes, please explain.*

How would you handle an unexpected vet bill of $500 or more? Explain.*

Are your current animals up to date on all vaccinations and vetting? Please provide the name & phone number of your current veterinarian. If you do not have a current vet, please provide the name & phone number of your last vet.*

Are you willing to allow a volunteer of Paws Crossed Dog Rescue to visit your home during the application process and after potential adoption?*

Does anyone in the household suffer from allergies to animals? If yes, please explain how it is planned to be controlled.*

How would you address behavioral issues such as jumping on furniture, growling, biting, house training, chewing on shoes, jumping on people, etc? How will you address any shedding issues?*

Do you intend to crate your new dog? Do you own a crate? Are you experienced with crate training? Please explain.*

What is your current occupation?*

What is the occupation of the Co-Applicant?

Do you work full time? part time? retired? attend school? Tell us about your typical week in terms of hours spent outside the home.*

If approved to adopt, do you intend on spaying / neutering your new animal? If not, why not?*

Do you own, rent, or live with relatives?*

If you rent, does your landlord allow animals? Please explain, and provide name & phone number of landlord.

Do you live in a single family home, condo, apartment, school dormitory, townhouse, or other type of dwelling? Please explain.*

How long have you lived at your current residence? If less than 5 years, please provide previous addresses.*

Do you understand that if you moved to a place that does not allow pets, that your adopted animal must be returned to Paws Crossed Dog Rescue?*

If you died, or became incapacitated, who would care for your adopted pet? Please provide name, address, email, and phone number.*

Will this dog be an outside dog, or inside dog?*

When outside, describe where your dog will be. Examples: on leash, on tie-out, in unfenced yard, in fenced yard, etc.*

Explain where your dog will be while you're at home, away from home, and while you're sleeping.*

Is your yard fenced? Please DESCRIBE the outside area of your residence, i.e., front yard, back yard, etc. If you have a fenced in area, please DESCRIBE THE STYLE of fencing & style of gate that is used.*

Are all of your current animals spayed or neutered? If not, why not?*

Tell us about the type of food that you are feeding your current dog(s), or were feeding your previous dog(s). Please include specific brand name and style of food.*

Regarding your current & previous dogs - tell us about heartworm testing and heartworm preventative medicines that were administered, if any. If none, please respond appropriately.*

Have you ever had a pet that was lost, stolen, or tragically hurt or killed by accident? Have you ever given away or re-homed a previous pet? Please explain.*

Have you ever adopted an animal from Rescue or a Shelter before? Please explain. Include dates, name of shelter / rescue, etc. *

Are you currently working with any other shelters, rescues, or breeders to find a suitable dog? If yes, please provide details.*

Are you willing to provide your new pet with training classes? Please explain.*

Please provide 3 personal, UNRELATED references. Include name, address, phone number, AND email address. 1 should be a neighbor. Please let your references know that we contact them via email. Failure to provide all of the necessary information will delay or stop the processing of your application. Please let your references know that we will contact them soon. We need NAME/ADDRESS/PHONE NUMBER/EMAIL ADDRESS for all 3 references. If the information is not included, incomplete, or partial, we will NOT move forward with processing your application.*

By submitting this online adoption application, do you understand that if you are denied the ability to adopt, that we will not provide you with any reasons or explanations or how that decision was determined? All decisions are confidential, and final.*

Please read carefully: by signing below (including electronic signature or typing your name in the field below), I certify that I understand that adopting any animal is a serious responsibility. The animal you adopt today will likely be part of your family for the next 10 to 15 years. Animals make demands on your time & resources. As guardian of said animal, you will need to spend time training, socializing, grooming, feeding, scooping feces, exercising, and playing with your companion animal every day. All companion animals require proper medical care. Some animals require special food, grooming, &/or medications. Vet bills, costs of a pet sitter, boarding fees, etc may add considerable expense to a family's budget. By signing below, you are stating that you are prepared and accept the personal and financial responsibility of owning a dog.*

By signing below (including electronic signature or typing your name in the field below), I certify that the information provided in this adoption application is true & accurate. I understand that any misrepresentation of facts will result in losing adoption privileges. I also understand that the adoption of this pet may be delayed until information can be verified. I authorize the investigation of all statements included in this application and know that veterinarians, landlords, and personal references may be contacted and I authorize the persons / entities listed above and/or their personnel to disclose to a representative of Paws Crossed Dog Rescue information that they possess regarding myself, my family, and the treatment and services of my current and/or former pets. I also understand that a background investigation may be done as part of the application process. I understand that any denial of adoption is confidential, and I will not be provided with information or details about how that determination was made. I understand that all adoption decisions are final.*