Date (required)
First and Last Name (required) Street Address (required)
City (required)
State (required)
Zip (required)
Phone (required)
Your Email (required)
Employer
Work phone
Driver’s License No (required)
Issuing State (required) AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming--District of ColumbiaPuerto RicoGuamAmerican SamoaU.S. Virgin IslandsNorthern Mariana Islands
Are you applying to adopt a: DogPuppyCatKitten
If cat/kitten, are you planning to declaw? Why or why not?
Is this your first experience with a pet? YesNo How many dogs/cats have you owned in the past?
Dogs (required)
Cats (required)
If you have a specific animal in mind, what is the animal’s name?
Have you ever adopted an animal from DAWS? YesNo If so, when? Have you previously submitted an adoption application to DAWS? YesNo If so, when? Why do you want to adopt a pet? Check all that apply. (required) CompanionWatchdogBarn Cat/MouserBreedingHuntingFamily PetChild’s PetCompanion for Another PetGuard Dog for BusinessOther
Do you currently or have you had any pets in the last 5 years? Please select below (required) -- Please Choose --YesNo
Please enter information for any pets you have owned in the past 5 years, including current pets:
Pet 1:
Name
Breed/Species
age
Neutered/Spayed?
YesNo
Declawed?
Alive/Deceased?
AliveDeceased
Veterinarian
Veterinarian Phone Number
Pet 2:
Pet 3:
Pet 4:
Pet 5:
Where do you currently live? HouseApartmentMobile HomeCondominiumTownhouse
Do you own or rent? (required) -- Please Choose --OwnRent
Landlord Name (required)
Landlord Number (required)
If you rent, does your lease/landlord allow pets? YesNo
How many hours a day will the pet be alone? (required)
Our pet will live (required): Indoors OnlyIndoors/OutdoorsPrimarily Outdoors
Do you have a fenced in yard? YesNo
Number of Adults (required): onetwothreefourfivesixseveneightnineten
Do you have children (required)
-- Please Choose --YesNo
Number of Children: (required)
-- Please Choose --noneonetwothreefourfivesixseveneightnineten
Ages of Children: under 1 year1 year2 years3 years4 years5 years6 years7 years8 years9 years10 years11 years12 years13 years14 years15 years16 years17 years18 years
Do all the adults in the household know that you plan to adopt a pet? (required) YesNo
Please check any topics that you would like to discuss with us: House TrainingIndoors vs. OutdoorsSeparation AnxietyChewingFeedingCrate TrainingExercise RequirementsPets and ChildrenObedience TrainingEscapingDisaster PreparationHeartwormsVaccinationsIntro. to Other AnimalsLeash/Licensing lawsMicrochipping
I would consider my household to be like A libraryMiddle of the roadA carnival
I am comfortable with a cat that likes to play “chase my ankles” and similar games NoSomewhatYes
I want my cat to interact with guests that come to my house Little of the timeSome of the timeAll of the time
How do you feel about a boisterous cat that gets into everything? Love them but rather not to live with themDepends on the situationFine by me
My cat needs to be able to adjust to new situations quickly Not importantSomewhatYes
I want my cat to love being with children in my home It’s not important whether my cat loves being with childrenSome of the timeMost of the timeChildren do not often come to my house
My cat needs to be able to be alone More than 9 hours per day4 to 8 hours per dayLess than 4 hours per day
When I am at home, I want my cat to be by my side or in my lap Little of the timeSome of the timeAll of the time
I want my cat to enjoy being held Little of the timeSome of the timeMost of the time
I need my cat to get along with dogscatsBirdsOther
My cat will be InsideInside and OutsideOutside
I have lived with cats before YesNo I prefer my cat to be talkative YesNoIt’s not important if my cat is talkative I want my cat to play with toys Little of the timeSometimesOften I want my cat to be active Not very active at allSomewhatYes, very
It's most important to me that my cat ...
My dog needs to be able to be alone (per day) 2 hours or less2-4 hours4-8 hours8-10 hours12 hours
When I'm at home, I want my dog to be by my side all of the timesome of the timelittle of the time
When I'm not at home, my dog will spend her time in the garagein a crate in the housein the yardloose in the houseconfined to one room in the house
I want a guard dog yesno
I want my dog to hunt or herd with me yesno
I want my dog to be the type that is very enthusiastic in the way she shows she loves people not at allsomewhatvery
I want my dog to be playful not at allsomewhatvery
I want my dog to be laid back not at allsomewhatvery
I am comfortable doing some training with my dog to improve manners such as jumping, stealing food, and pulling on the leash no trainingsome traininga lot of training
I (or my children) want to participate in agility, flyball or obedience with our dog. yesno
I am interested in a dog with "special needs" (medical or behavioral) yesno
It's most important to me that my dog ...
Please Enter 3 references below
Reference 1:
Reference Name
Phone Number
Relationship to Applicant
Reference 2:
Reference 3:
I understand that DAWS reserves the right to approve or deny any adoption application, and the completion of this application does not guarantee an adoption of a DAWS animal. I affirm that I have answered all questions truthfully and to the best of my knowledge. I also represent that I am willing and able to accept full and immediate responsibility for the ownership and care of the animal(s) I am applying to adopt.
I Confirm (*Required for application submission)
