Family Pet Application -

Requested Pet Name *

Personal Details

Potential Pet Parent Name *

First

Last

Birthday of person applying

Email *

Phone *

Home Information

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Do you rent or own? *

If you rent do you have landlord approval?

If yes to landlord approval please provide their email or phone so we can contact them

How many hours a day are you home (during the daytime)? *

Current Pet Owner? *

What kind of pets, ages and how many? *

Do you have children in the home? *

Please list names and ages of everyone who lives in the home *

Does anyone in the family have a disability? What skills would a dog be able to help you with? If none say NA *

How active is your family? *

Very activie- we have many visitors, chidlren and animals in and out of our home
Somewhat active- we have a few people visit
Quiet- our home does not see many animals, children or other visitors

Where do you plan to keep a dog? (check all that apply) *

In Family home – loose
In Family home- kennel
In back yard full time or more then 60% of the day
In a garage or kennel setting

Yard Size *

Is your yard fenced? *

Please include photos of the applicant’s home and yard. *

Drag & Drop Files, Choose Files to Upload You can upload up to 3 files.

What dog behaviors are you NOT willing to work on through with training with a new in your home? (check all that apply) *

Barking at noises around the home/ yard
Pulling on the leash
Making noises in a kennel
Excited behaviors with visitors to the home
Fear of new people or things
*** I am willing to work on all these behviors with a new dog to my home

Do you have any dog training experience or general dog experience? *

Vet/ Animal Info

Name and Address of current/ past Vet *

Vet Phone *

Will you provide yearly vet care to the dog including; vaccines? (cost 500$ a year estimated) *

Yes
No

Will you provide monthly flea and heartworm medication to a dog (cost estimated $300 a year) *

Yes
No

If applying for a poodle or doodle can you afford $60-$100 every 6-8 weeks to profesionally groom the dog *

Yes
No
NA- I dont want a poodle/ doodle

How do you plan to exercise your dog? *

Please describe any experience you have with taking care of a dog *

Are you only interested in a specific breed? If yes please provide details *

Have you ever given away a pet? If Yes please explain *

Has the applicant or anyone in the home been convicted of felony AND/OR animal cruelty or neglect by a humane organization? If yes please explain *

Please tell us who will care for your pet when you travel. *

How did you hear about us? *

Personal Reference Details

Name *

First

Last

Email *

Phone

I agree *

By signing this I understand Paws Giving Independence reserves the right to deny any applicant for any reason. I understand Paws Giving Independence does not have to give me a reason for a denial of an animal. In my participation with Paws Giving Independence and Helping Paws I do hereby agree to hold free from any and all liability the Paws Giving Independence/Helping Paws and its members, board members, staff, volunteers and officers. My family, members of my household and myself waive the rights and claims for damages and injuries, which may come from connection and participation with PGI. I declare myself to be physically sound to participate with the PGI. I understand PGI can remove a dog from my home at any time due to failure to fulfill these terms, conditions, policies, and procedures of Paws Giving Independence. I understand any dog that is placed with me through Paws Giving Independence will legally belong to Paws Giving Independence until adoption paperwork is signed. I understand any dog that is placed in my home will be placed as a family pet and not a working service dog, facility dog or in home service dog. By providing my vet information I am giving PGI permission to contact them.
The application does not guarentee me a dog from Paws Giving Independence
I understand the family pet adoption fee starts at 699$ but maybe adjusted based on the dog

PGI prohibits discrimination based on race, sex (including pregnancy, childbirth or related medical conditions), religious creed, color, national origin or ancestry, physical or mental disability, medical condition, marital status, age, sexual orientation, citizenship status, military service or veteran status, gender identity and gender expression or any other basis protected by federal, state or local law or ordinance or regulation.

Signature *

Clear Signature