DOG Adoption Pre-Screening Application
Dog adoption Pre-screening form - required for interacting with animals (meet and greets).
PAWS of Grays Harbor
Which animal(s) are you interested in?
Applicant's First Name
*
Applicant's Last Name
*
Street Address (include apartment/unit number if applicable)
*
City
*
County
*
State
*
Phone Number
*
Alternate Phone Number
Email Address
Employment Status
Full-Time
Part-Time
Retired
Work from Home
Stay at Home Parent
Student
Unemployed
Other
If you chose "other" above, please explain:
Is this pet for you or someone else?
*
Myself
Someone else
Including yourself, how many people live in your household?
*
Please list the ages & relationship of those who live in your home.
*
Is everyone in your household aware that you are planning to adopt a pet?
*
No
Yes
Please select your current residence type.
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House
Apartment
Condo
Townhouse
Mobile Home
Other
If you answered "other" above, please explain here:
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Do you own or rent your home? (If you live in a mobile home park with space rent, please choose Rent and provide landlord information)
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Own
Rent
Someone else owns the Home
Someone else rents the Home
If you are not the landlord/home owner, please provide their name and contact information:
*
Do you have a completely fenced-in yard? If so, what kind of fence?
*
Wood
Chain Link
Electric
Plastic
Iron
Other
Other (I do not have a fenced yard)
If you answered "other" above, please explain:
Do you own other pets at the current time?
*
No
Yes
Please list their names, breeds, and ages.
Are all of your pets spayed/neutered/fixed?
No
Yes
If no, please explain why:
Are your pets current on their vaccinations?
No
Yes
If no, please explain why:
Were any of your pets obedience trained?
No
Yes
Will your other pets adjust to a new pet in the house?
Yes
No
Unsure
How many pets have you owned in the last 5-10 years?
*
Have you ever turned your dog or cat into a shelter?
*
No
Yes
If yes, please explain:
Have you ever had a pet euthanized for reasons other than illness/old age?
*
No
Yes
If yes, please explain:
Please check the main reason you plan to adopt a pet:
*
Companion
Family Pet
Child's Pet Guard Dog
Companion for another pet
Other
If you answered "other" above, please explain here:
Please describe in detail the type of pet you are looking for.
*
Have you applied anywhere else for a pet within the last 6 months?
No
Yes
If yes, where else have you applied for a pet?
Will this pet be predominantly living inside, outside, or both?
*
Inside
Outside
Both
If you do not have a fenced yard, how will you let the animal out?
*
Are there times when the animal will be tied/chained up?
*
No
Yes
If yes, when will they be tied/chained up?
Will the animal spend any time in the garage?
*
No
Yes
If the animal will spend time in the garage, please explain when/why:
Where will the pet sleep?
*
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
If you answered "other" above, please explain:
Are you willing and able to exercise the pet on a regular basis?
*
No
Yes
What is the main method of exercise?
On average, how many hours per day will the pet be left alone?
*
How will you handle housebreaking?
*
How will you handle destructive behavior?
*
For what reason(s) would you consider returning/giving up the pet?
*
If you drive a pick up truck, would you allow the pet to ride in the back/bed?
*
Yes
No
N/A
What would you do with your pet if you had to move?
*
Take him / her with me
Give to family or friend
Return to shelter
Other
If you answered "other" above, please explain:
What will you do with the pet when you go on vacation?
*
Leave with family/friend
Boarding
Pet sitter
Take with me/us
Other
If you answered "other" above, please explain:
What arrangements will you make for the care of your pet in case of an emergency?
*
Leave with family/friend
Boarding
Pet Sitter
Take with me/us
Other
If you answered "other" above, please explain:
Will you allow us to perform home checks?
*
No
Yes
Have you ever been convicted of abuse or neglect of a child or animal?
*
No
Yes
If yes, please explain:
What is your preferred method of contact?
*
Phone
Email
Text
How did you find out about us?
Petfinder
Internet Search
Family/Friend
Staff/Volunteer
Facebook/Twitter
Other
I have read the foregoing and certify that the answers I have given are complete, true and not misleading in any way. I understand that anything submitted in this application found to be untrue will result in the forfeiture of any PAWS of Grays Harbor animal adopted or fostered by me. I understand that PAWS of Grays Harbor may verify any or all information submitted in this application from Landlords, Property Companies and/or Veterinarians before approval may be given. I understand that this application does not ensure I will be approved.
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No
Yes
Signature
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Clear
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