The PCAWL Tail Trot 5K/10K at Veterans Memorial Park in Rolla on June 20, 2015. Photos by Sam O'KeefeAdoption Application

Thank you for your interest in adopting! This application is intended to aid both you and us in deciding if the animal you have chosen to adopt is appropriate for your home. We want to find a pet that is compatible with your life-style, and a home for the animal that meets the pet’s needs.

Note: Since our organization does place courtesy posts on Petfinder as a service to local rescuers, this form is acceptable to use for such non-PCAWL animals. Just be sure to specify the pet’s name you are interested in and we will forward it on to the appropriate person.

 

 

 

Name of Animal you are Interested in:

Your Name

Address

City

State

Zip

Primary phone

Work phone

Email

Why are you considering adoption now?

Does everyone in household (if more than one adult) want a new pet?
YesNoN/A

Type of Residence
HouseApartmentMobile HomeOther

Do You:
OwnRent

If rental, are cats and dogs allowed?
YesNo

How many adults in your household?

How many children in your household?

Ages of Children:

Does anyone in your household have allergies to animals?
YesNo

How many hours per day will the pet be alone?

Where will the pet stay when left alone?

Are you willing to allow a routine home visit prior to adoption?
YesNo

If adopting a dog, do you have a fenced yard?
YesNo

Have a pet door?
YesNo

What kind of accommodations will you have for your pet during cold weather?

Many pets lose their homes because people move. Would you move someplace you couldn’t take your pets?
YesNo

Employment Status:
EmployedUnemployedRetiredStudent

If employed, please list your employer:

Have you ever had to give up a pet or turn one in to animal control?
YesNo

If so, what were the reasons?

In case you experience a life change (for example, a move, a divorce, a new baby), how will this affect the animal?

____________________________________________________________________________________________

CATS ONLY:

Are you going to declaw the cat?
YesNo

Are you going to allow the cat outdoors?
YesNo

If so, why do you think the cat will be safe?

If this cat climbs on things, claws the furniture, develops a problem using the litter box, or has an attitude, what will you do about it?

____________________________________________________________________________________________

DOGS ONLY:

How many hours will this dog be outside?

Would this dog be allowed inside the house?
YesNo

If not allowed inside, can you provide reasons?

Would you ever leave this dog tied up outside?
YesNo

If yes, please explain:

How will you deal with any “accidents” or other behavior (digging holes, barking, etc.) that the dog might have?

What type of training will you use?

____________________________________________________________________________________________
Please list the last three pets that you have had:

Pet (Most Recent)
Name of Pet: Age: Sex: MF
Type/Breed: Neutered? YesNo

Still have pet? YesNo
If not, what happened to the pet?

Pet (Second Most Recent)
Name of Pet: Age: Sex: MF
Type/Breed: Neutered? YesNo

Still have pet? YesNo
If not, what happened to the pet?

Pet (Third Most Recent)
Name of Pet: Age: Sex: MF
Type/Breed: Neutered? YesNo

Still have pet? YesNo
If not, what happened to the pet?

____________________________________________________________________________________________

Please list two personal references who are not relatives.
Contact Name Relationship Phone
Contact Name Relationship Phone

I grant Phelps County Animal Welfare League permission to contact the references above as well as my veterinarian for access to all existing pet medical records.

If, for any reason or at any time, I am unable to care for my adopted pet, I agree to return my adopted pet to PCAWL; I further agree never to abandon my adopted pet or release my adopted pet to an animal shelter or research facility. However, before relinquishing my adopted pet back, I agree to exhaust all options available to me, including, but not limited to, a behaviorist, or veterinary advice to solve any physical or behavioral problem that may occur.

I agree that by accepting my pet for adoption, I am accepting responsibility for the animal. I understand this means that Phelps County Animal Welfare League is not responsible for any damage to person or property that may be caused by my adopted pet after the date of adoption and I accept full responsibility for my adopted pet from the date of the adoption forward.

I hereby declare that the above information is true and correct to the best of my knowledge.

If you have any questions, please email us. Thank you for your interest in adopting a rescued pet and saving a life.