Animal Adoption Application Form printable pdf download

__________

__________ __________

Date

Name

Tag

Perfect Pet Rescue, Inc.

10737 Venice Boulevard. Los Angeles, California 90034

Tel (310) 726-3731 or (310) 559-3770 Fax (310) 550-0121

ANIMAL ADOPTION APPLICATION

*** Completion of this application does not guarantee adoption of a Perfect Pet Rescue animal ***

Name of applicant ____________________________________________________ Occupation ________________________

Name of Spouse/Significant Other _______________________________________ Occupation ________________________

Names (and ages) of children, if any ________________________________________________________________________

Street Address _________________________________________ City ______________________ State ______ Zip _______

Home Phone ________________________ Work Phone __________________________ Cell Phone ___________________

Email Address__________________________________________________________________________________________

Emergency Contact - Name _________________________________ Best phone number to reach_______________________

Do you live in a House _______ Apartment ________ Condominium _______ Townhouse _______ Other ________________

Landlord’s Name and Phone Number ________________________________________________________________________

Do you Own _______ Rent _______ If you rent, do you have your landlord’s permission to have a pet? Yes _______ No _____

How much of the time will the dog be outdoors? ____________________ How much time indoors? _____________________

About what percent of the time will the dog be left alone without humans? __________________________________________

Where will the dog be when left alone? ______________________________________________________________________

What area(s) of the house will the dog be allowed into? _________________________________________________________

What area(s) of the house will the dog NOT be allowed into? ____________________________________________________

Where will the dog sleep at night? __________________________________________________________________________

Do you have a dog proof fenced yard? Yes _______ No _______ if yes, how high is the fence? _________________________

Type of fence? __________________________________________ Are the gate(s) normally locked? Yes _____ No ______

Do you have a doggy door? _______Yes _______ No

Do you have a pool? Yes _______ No ______ If yes, is it fenced separately from the yard? Yes ________ No ________

Why do you want a dog? (Check all that apply)

______ House pet

______ Companion for family

______ Companion for other pet

______ Companion for children

______ Protection for home/family

______ Protection for business

______ Watchdog

______ As a gift ______

______ Other (specify) ________________________________________________________________________

PPR ANIMAL ADOPTION APPLICATION - Page

Animal Adoption Application Form