Paw's Place

A No-kill, Non-Profit Animal Rescue, Rehabilitation and Retirement Facility
3701 Boiling Spring Road, Winnabow, NC 28479
(910) 845-PAWS

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PRE-ADOPTION APPLICATION

Welcome to Paw's Place Adoption Program. We're glad that you are interested in adopting a new pet from us. The following information is requested, so that we can assist you in the selection of a new pet. The application process of a form and consultation with a Paw's Place representative, is designed to help us determine if the adoption is in the animal's best interest, and to assist you in finding an animal most compatible with your lifestyle. Please fill out and give to a Paw's Place representative, or mail this form to Paw's Place, Inc., 3701 Boiling Spring Road, Winnabow, NC 28479 or fax to (910) 845-8622.

NOTE: In order to be considered as an adopter, you must:

  1. have a vet recommendation. This means we will call your vet to see if the dog you had, or have is up to date on shots, spayed or neutered and on heartworm preventative;
  2. be at least 21 years of age;
  3. have a fenced back yard;
  4. own your own home, or rent for at least 2 years at the same address;
  5. have consent of your landlord if renting, and provide a copy of the lease or a letter from landlord;
  6. provide a driver's license at adoption time that matches your current address;
  7. be able and willing to spend the time and money necessary to provide training, medical treatment and properly care for a pet.

Completion of this application does not guarantee adoption of a Paw's Place dog.
Please print.

Name of Applicant: ________________________________________________________

Physical Street Address: ____________________________________________________

Mailing Address (if different) ________________________________________________

City/State/Zip: ____________________________________________________________

Area Code and Home Phone #:(_______) _____________________
Cell # (_____)_________________

Describe in detail the dog(s) you are looking for:

__________________________________________________________________________

__________________________________________________________________________

Would this be your first dog? __________

What kind of dog(s) or cat(s) have you had in the past? ___________________________

__________________________________________________________________________

Which of these do you still have — include name, age, sex and breed:

___________________________________________________________________________

___________________________________________________________________________

Have they been spayed or neutered? ______________________

If not, why not:

___________________________________________________________________________

___________________________________________________________________________

What happened to the ones you no longer have?

___________________________________________________________________________

___________________________________________________________________________

If you have pets, will they/it adjust to a new dog in the house?

___________________________________________________________________________

___________________________________________________________________________

Why do you want this animal?

How many adults are there in your family? _____________

How many children? _____________________

Children's ages: _____________________________________________________________

Does any member of your household have an allergy to animals? ____________________

Is someone home during the day? ____________
Who? _________________________________________

How many hours each day will the dog be alone? _____________
Explain: _______________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

Which do you live in: ___House ___Apartment ___Condo ___Mobile Home (circle: single or doublewide) ___ Townhome Other: ________________________________

Do you own or rent your home?___Own ___Rent

If you rent, may we contact the owner to obtain permission for this dog to live in your home? ____Yes / No

Owner's name and phone number:

___________________________________________________________________________

Will you keep the dog up-to-date on vaccinations? ______________

Are you financially able to provide monthly heartworm & flea preventative? ___________

Employer __________________________________________________________________

Number of years with this employer ______________

Who was or is your veterinarian (clinic name)?

____________________________________________________________________________

City/Town: _________________________________

May we call your veterinarian to get a recommendation? ___________________
tel # (_____)_____________

If you go away for a few days, or on a vacation, who will take care of the animal?

___________________________________________________________________________

___________________________________________________________________________

If you are active military, who will guarantee long-term care of your pet until you return from duty?

___________________________________________________________________________

How: ______________________________________________________________________

Families and relationships break up, and people move. Can you guarantee a permanent home to this dog?

___________________________________________________________________________

How: ______________________________________________________________________

We are a coastal community. What will you do with the dog during a hurricane?

___________________________________________________________________________

___________________________________________________________________________

Are you willing to have a representative of Paw's Place come to see where the pet will be living? ___Yes / No

Are you willing to take the responsibility for this pet for the next 10-15 years? ________

Do you have a completely fenced yard (all 4 sides)? ________ Height of fence: ________

What kind of fence? _______________________

Is there a gate to the outside? ________________

What type of latch or lock? __________________________ If no gate, explain:

___________________________________________________________________________

___________________________________________________________________________

Do you drive a pickup? ____ Yes / No

Do you (or did you previously) allow a dog to ride in the back? ____ Yes / No

Method: _____loose _____chained _____tied _____crated

Would you allow your new pet to ride in the back of a pickup? ____ Yes / No

Would you be able and willing to exercise the dog on a regular basis?

___________________________________________________________________________

Method: ___________________________________________________________________

Where will this pet be kept during the day?

___________________________________________________________________________

During the night?

___________________________________________________________________________

Comments by applicant:

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

 

_______________________________________________________  
     Signature of Applicant     Date

 

TO BE FILLED OUT BY PAW'S PLACE AFTER CONSULTATION

Application for adoption ___Accepted ___Denied

Comment: _________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

Applicant Notified: ___Phone call ___Consultation

Paw's Place Representative: ________________________Date: ____________________