House of Paws Dog Rescue
Kannapolis, North Carolina 28083

First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

Email*

Home Phone*

Work Phone
x

Cell Phone

Alt Email

Name of dog you are applying to adopt?
Choose an animal: Birk Greta Hannah Peanut Penelope

When is the best time to call you?*

Date of birth?*

Drivers License #*

Place of employment and work phone*

What are the occupations of other adults in the household? Retired? Stay at home parent?*

How did you hear about us?*

Do you own or rent your home? *
Choose one: Own Rent Live with family

What type of home do you live in? *
Choose one: single family town home apartment mobile home farm

If you rent, please give the rules governing pets and the landlord’s name and number: (by providing this information you are allowing us to contact your landlord. Please inform them of this call so they will speak with us)

Have you adopted from us before?*
Choose one: Yes No

If yes, do you still have the pet?
Choose one: Yes No

List all adults living in the home, and their relationship to you.*

List all children in the home, and their ages. (If none, write none)*

List 3 references (name and phone #)*

Will this be an inside or outside pet?*

Do you have a fenced yard?*
Choose one: Yes No

If yes, what kind and how tall?

Where will the pet be kept during the day?*

How long will the pet be left alone during the day?*

What is the age preferred for a dog you want to adopt?*

What's the oldest you would consider adopting?*

What is the sex of the dog you prefer?*
Choose one: Male Female No preference

Would you be interested in any other dog?*
Choose one: Yes No

What will you do if your dog is destructive while alone?*

List unacceptable behavior issues*

How will you discipline your new dog?*

Will you attend obedience classes with your new dog?*
Choose one: Yes No

What would justify getting rid of a pet?*

List all pets currently in your household and the ones you have had in the past 5 years (Name, Breed, Spayed/Neutered?, Age , What happened if you no longer have them?)*

List your current and past vets (name and ph. #)*

NOTE: All pets in the home MUST be spayed/neutered, up to date on vaccines and heartworm prevention. If heartworm prevention was not purchased through your vet, you MUST provide proof.