DOG Adoption Pre-Screening Application

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

If you chose "other" above, please explain:

Is this pet for you or 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? *

Please select your current residence type. *

If you answered "other" above, please explain here: *

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) *

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? *

If you answered "other" above, please explain:

Do you own other pets at the current time? *

Please list their names, breeds, and ages.

Are all of your pets spayed/neutered/fixed?

If no, please explain why:

Are your pets current on their vaccinations?

If no, please explain why:

Were any of your pets obedience trained?

Will your other pets adjust to a new pet in the house?

How many pets have you owned in the last 5-10 years? *

Have you ever turned your dog or cat into a shelter? *

If yes, please explain:

Have you ever had a pet euthanized for reasons other than illness/old age? *

If yes, please explain:

Please check the main reason you plan to adopt a pet: *

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?

If yes, where else have you applied for a pet?

Will this pet be predominantly living inside, outside, or 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? *

If yes, when will they be tied/chained up?

Will the animal spend any time in the garage? *

If the animal will spend time in the garage, please explain when/why:

Where will the pet sleep? *

If you answered "other" above, please explain:

Are you willing and able to exercise the pet on a regular basis? *

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? *

What would you do with your pet if you had to move? *

If you answered "other" above, please explain:

What will you do with the pet when you go on vacation? *

If you answered "other" above, please explain:

What arrangements will you make for the care of your pet in case of an emergency? *

If you answered "other" above, please explain:

Will you allow us to perform home checks? *

Have you ever been convicted of abuse or neglect of a child or animal? *

If yes, please explain:

What is your preferred method of contact? *

How did you find out about us?

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. *

Signature *