Paws Animal Rehabilitation Center
PET ADOPTION APPLICATION
Application No.
Please Print this Application and bring it with you to the shelter
You
will still need to have an interview with an adoption counselor, prior to
approval of your application. Filling out this form will save time at the
shelter, but does not substitute for an in-person interview. Our shelter is
located at Aurora Boulevard corner Marcos Hi-way, Loyola Heights, Quezon City.
Shelter
Hours: Mon-Fri 10AM – 6PM, Sat/Sun 11AM – 5PM.
Name
_______________________________________ Home phone ______________________________
Address
___________________________________________ Work phone ________________________
City
_______________________________ Province _________________________ Zip
_____________
(please
sketch the location of your house at the back of this page)
Personal
Reference:
Name
_________________________________________ Relationship
___________________________
Phone
_____________________________ Are you 18 years or older? Yes ________ No
_________
What
prompted you to come to PARC (friends, printed ads, TV show)?
_____________________________________________________________________________________
Are
you interested in a: Cat _____ Kitten _____ Dog _____ Puppy _____ Other _____
Shelter
Tag No. _________________________ (if animal is available in the PARC)
Breed/Mix:
___________________________ Size: S _____ M _____ L _____ XL _____ Age
__________
1.
Why
did you decide to adopt an animal?
_______________________________________________________________________________
2.
Have
you adopted from PAWS/PARC before? Yes _____ (dog ___ Cat ___)
When?______________ No _____
3.
Do
you live in a: House _____ Apartment _____ Condo _____ Townhouse _____ Other
_____
4.
Do
you Rent? Yes _____ No _____: If yes, please secure a written letter from your
landlord granting you permission to keep pets.
5.
Do
you live with Parents? _____ Spouse _____ Roomate(s) _____ Alone _____ Children
_____ Other ___________
6.
How
long have you lived in this address?
____________________________________________
7.
Are
you planning to move in the next 6 months? Yes _____ No _____
If yes, where
____________________________________________________________________
8.
I
am adopting this animal for: Myself _____ Children _____ as a Gift _____ Other
____________
9.
Will
the whole family share in the care of the animal? Yes _____ No _____
10.
Is
there anyone in your household who has objection(s) to the arrangement? Yes
_____ No _____
If yes, explain
_______________________________________________________________________________
11.
Are
there any children that visit your home frequently? Yes _____ Age range?
_______ No _____
12.
Are
there any other regular visitors to your home, human or animal, with which your
new companion must get along? Yes _____ No ______
If yes, explain
_______________________________________________________________________________
13.
Are
any members of your household allergic to cats/dogs? Yes _____ No _____
If yes,
who?_________________________
14.
What
will happen to this animal if you have to move unexpectedly?
_______________________________________________________________________________
15.
What
kind of behavior(s) do you feel unable to accept?
_______________________________________________________________________________
16.
How
many hours in an average workday will your companion animal spend without a
human?
______________________________________________________________________________
17.
What
will happen to your companion animal, when you go on a vacation or in case of
emergency?
_______________________________________________________________________________
18.
Do
you have a regular veterinarian? Yes _____ No _____ Name
___________________________
19.
Do
you have other companion animal(s) in the past Yes _____ No _____ Type _______________
20.
Do
you want this animal to be Inside only _____ Inside/outside _____ Outside only
_____
21.
Where
will this animal be kept during the day? ________________________
night?
______________________________
22.
Do
you have a fenced yard? Yes _____ No _____ Fence height and type
____________________
23.
If
adopting a dog, does fencing completely enclose the yard? Yes _____ No _____
If no fence, how will you
handle the dog’s exercise and toilet duties?
_______________________________________________________________________________
24.
If
adopting a cat, where will the litterbox be kept?
Inside house _____ Garage
_____ Other location _____ No litterbox needed _____
25.
As
a matter of policy, PARC will neuter all animals prior to releasing for
adoption. What is your opinion about spaying and neutering (kapon) of
companion animals?
_______________________________________________________________________________
26.
Do
you have any questions or comments?
_______________________________________________________________________________
I certify that the above
information are true and understand that false information may result in the
automatic nullification of my proposed adoption. PARC reserves the right to
refuse an adoption.
Applicant’s Signature
__________________________________
Parent co-sign if under 18
years ___________________________
Date ______________________