Hands to Paws Adoption Application
What species are you looking to adopt?
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Bird
Cat
Chicken
Chinchilla
Dog
Ferret
Gerbil
Guinea Pig
Hamster
Rabbit
Is there a specific animal in our rescue you are looking to adopt?
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No
Yes
Animal you are interested in adopting
Please describe in detail the type of pet you are looking for.
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Applicant's First Name
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Applicant's Last Name
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Street Address
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Apartment Number (if applicable)
City
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State
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Zip Code
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Home Phone Number
Cell Phone Number
Email Address
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Date of Birth
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Driver's License Number
Driver's License State
How did you find out about us?
Petfinder
Internet Search
Family/Friend
Staff/Volunteer
Facebook/Twitter
Other
Have you applied anywhere else for a pet?
No
Yes
Where else have you applied for a pet?
Is this pet for you or someone else?
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Myself
Someone else
Reason for applying on behalf of someone else
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Do you own other pets at the current time?
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No
Yes
Are your pets current on their vaccinations?
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No
Yes
List their names, breeds, and ages.
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Are all of your pets spayed/neutered/fixed?
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No
Yes
Why are your other pets not altered?
How many pets have you owned in the last 5-10 years?
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0
1
2
3
4
5
More than 5
What happened to them? Select as many as needed.
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Death
Still With Me
Lost
Gave Away
Other
Provide an explanation if you selected that the animal died, was lost, was given away, or other.
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Were any of your pets obedience trained?
Yes
No
N/A
Veterinarian's Name
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Veterinarian's Address, City, State, and Zip Code
Veterinarian's Phone Number
Have you ever had a pet euthanized?
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No
Yes
Please explain:
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Have you ever declawed a cat?
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No
Yes
Pets should be spayed / neutered.
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Agree
Disagree
Not Sure
Do you plan on declawing your new cat(s)?
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No
Yes
Are you familiar with heartworm and heartworm prevention?
No
Yes
How will your current pets adjust to a new pet in the house?
Please check the main reason you plan to adopt a pet:
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Companion
Family Pet
Child's Pet
Guard Dog
Companion for another pet
Other
Explain why you chose "Other".
Do you own or rent your home?
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Own
Rent
Someone else owns the home
Someone else rents the home
Does your landlord and lease allow pets?
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Yes
No
Unsure
Please select your current residence type.
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House
Apartment
Condo
Townhouse
Mobile Home
Other
Explain why you chose "Other".
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How long have you lived at this address?
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Less than one month
1-2 months
3-6 months
6-9 months
9-12 months
1-2 years
3-5 years
6-10 years
10 + years
Including yourself, how many people live in your household?
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1
2
3
4
5
More than 5
List the ages & relationship of those who live in your home.
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Is everyone in your household aware that you are planning to adopt a pet?
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Yes
No
Does anyone in your household have allergies to dogs/cats or asthma?
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Yes
No
Unsure
Please explain the allergies or asthma.
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Employment Status
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Full-Time
Part-Time
Retired
Work from Home
Stay at Home Parent
Student
Unemployed
Other
If you chose "Other" for Employment, explain.
What is your current occupation?
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On average, how many hours per day will your pet be left alone?
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How much do you think the annual medical bills will be for your pet?
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About $100
$100 - $200
$200 - $300
$300 - $500
$500 +
What would you do if the bills went over this amount?
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Will this pet be predominantly living inside, outside, or both?
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Inside
Outside
Both
Please provide a description of your new pet's living conditions.
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What type of fence do you have?
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Wood
Chain Link
Electric
Plastic
Iron
Other
I do not have a fenced yard
Explain why you chose "Other".
If you do not have a fenced yard, how will you let the animal out?
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Are there times when the animal will be tied/chained up?
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No
Yes
When will they be tied/chained up?
Where will the animal sleep?
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In bed with me
In bed with my child
In a dog / cat bed
In a kennel / crate
Wherever he or she likes
Outside
Other
Explain why you chose "Other".
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Will the animal spend any time in a garage?
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No
Yes
When would the animal be in a garage?
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Do you have a pool?
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No
Yes
Is there a fence around the pool?
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No
Yes
What kind of fence do you have around your pool?
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Wood
Chain Link
Plastic
Iron
Other
Explain why you chose "Other".
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How will you handle housebreaking?
How will you handle destructive behavior?
Will you keep the animal up-to-date on vaccinations (cats and dogs) and heartworm preventative (dogs)?
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No
Yes
Explain why you chose "No".
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Are you willing and able to exercise the dog on a regular basis?
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No
Yes
What is the method of exercise?
Walking
Running
Dog Park / Dog Run
Other
Explain why you chose "Other".
Have you ever been convicted of abuse or neglect of a child or animal?
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No
Yes
Explain:
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Do you drive a truck?
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No
Yes
Would you allow the animal to ride in the back/bed?
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No
Yes
What arrangements will you make for the care of your pets in case of an emergency?
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Leave with family/friend
Boarding
Pet Sitter
Take with me/us
Other
Explain why you chose "Other".
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What will you do with the animal when you go on vacation?
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Leave with family/friend
Boarding
Pet sitter
Take with me/us
Other
Explain why you chose "Other".
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For what reason(s) would you consider returning/giving up the animal?
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What would you do with your animal if you had to move?
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Take them with me
Give to family or friend
Return to shelter
Other
Explain why you chose "Other".
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Are you willing to take responsibility for this animal for the next 10-20 years?
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No
Yes
Explain why you chose "No".
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Will you allow us to perform home checks?
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No
Yes
Are you or anyone in your house military?
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No
Yes
Are you subject to transfer or deployment?
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No
Yes
Explain what would happen to your new pet if you were transferred or deployed.
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Provide two non-family references
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I have read the foregoing and certify that the answers I have given are complete, true and not misleading in any way. I am authorizing you to contact landlords, associations and veterinarians. I am also aware that we cannot guarantee the health and temperament of the animal.
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No
Yes