2PawsUp Adoption Form

Name of adopter(s):*

Type of pet you're interested in:*

Dog/Puppy
Cat/Kitten

Name of animal(s) you are interested in:*

Email:*

Mailing Address:*

Street Address Address Line 2 City State ZIP Code

Residence address (if different than the mailing address):

Street Address Address Line 2 City State ZIP Code

Home phone:

Mobile phone:*

Are you 21 years or older?*

Yes
No

Does anyone in the home have allergies to animals (please describe)?*

How many people live in the household?*

Children's ages:

Who in the household will be responsible for caring for the animal and their age?*

Indicate the type of area you live in:*

Urban(City)
Residential(Town)
Agricultural(County)

Please indicate which of the following best describes your home:*

House
Mobile Home
Apartment/Townhome

If you live in a mobile home, is it a privately owned property?

Yes
No

Please indicate if you rent or own your property:*

Rent
Own

Please provide your landlord's name and phone number:*

Section 1: HISTORY OF YOUR PET(S)

What pets have you owned in the past five years?*

Type, Breed, Age	Name	Spayed/Neutered	Still have the pet?

If you no longer have any of the above pets, please explain what happened to them:

Have you previously adopted an animal from a shelter?*

Yes
No

Have you ever taken an animal to a shelter?*

Yes
No

Please state the name and phone number of your veterinarian:*

When was your last visit to the vet?

What was the reason for your visit?

May we contact your vet?*

Yes
No
Do not have a vet

We must have permission in order to process your application

Are your pets listed under your name?*

Yes
No
Do not have a vet

If not, who's name is listed?*

Section 2: FOR CAT ADOPTION—ALL ANSWERS MUST BE FILLED IN FOR CONSIDERATION

Why did you decide to get a new cat?*

Cat will be:*

Indoor
Outdoor
Both

Please explain your reasoning for this decision:*

Do you plan to declaw?*

Yes
No

Please explain your reasoning for this decision:*

Under what circumstances would you not be able to care for this cat?*

How do you plan to discipline this animal and/or discourage unwanted behavior (i.e. jumping on counters, scratching furniture, etc.)?*

What is your reason for choosing this particular cat?*

Section 3: FOR DOG ADOPTION—ALL ANSWERS MUST BE FILLED IN FOR CONSIDERATION

Why did you decide to get a new dog?*

Please provide a sentence or two on what you know about heartworm disease.*

How often will your new dog receive heartworm prevention and heartworm testing?*

Do you have a completely fenced yard?*

Yes
No

How do you plan to exercise this dog?*

How do you plan to discipline this dog?*

Under what circumstances would you not be able to care for this dog?*

Where will this dog sleep at night?*

Where will this dog be kept during the day?*

How many hours will this dog be alone each day (average)?*

What is your reason for choosing this particular dog?*

Section 4: GENERAL QUESTIONS—ALL ANSWERS MUST BE FILLED IN FOR CONSIDERATION

How often will you bring your new pet to the vet for regular checkups and vaccinations?*

How much do you plan on spending yearly on medical care for this pet?*

How much would you be willing to spend on a medical emergency for this pet?*

If you had to move, how important is it that your new home allows pets?*

How long do you expect your new pet to be a part of your life?*

Personal Reference #1*

Name and Relationship	Email address

Please contact your references to alert them that we will be emailing them. This will speed up the application process.

Personal Reference #2*

Name and Relationship	Email address

Please contact your references to alert them that we will be emailing them. This will speed up the application process.

In an emergency, if something should happen to you and/or you are no longer able to care for the pet(s), who will be the caretaker of your animal(s)?*

By signing/submitting this adoption application, I am accepting all risks associated with handling animals during the adoption process and release 2PawsUp from all liability.

I also further attest that the information given is true. I realize that giving false information may result in being denied.

I agree to release all veterinary records pertaining to any animals in my household. I realize that I must come to the animal’s foster home to visit this pet before approval, and that I will be required to pick up the pet at a later determined time and location.

Name and Date:*

Signature (name):	Date: