Adoption Form

Fields followed by an asterisk (*) are required.

Your Name *
Dog You're Interested In *
Street Address *
City *
State *
Zip *
Phone # *
Email *
Date of Birth *
Employer Name *
Year's Employed *
Employer Phone *
# of Adults in the Home *
Adult's Ages
# of Children in the Home *
Children's Ages
Own a Home or Rent *
If rental, please provide landlord's phone #
Type of Home *
Yard *
Street Type *
May we visit your home? *
Any additional Information which helps describe your home environment?
Primary caregivers work schedule *
Describe how the dog will be maintained while away or at work. *
Have you had animals in the last 10 years? If yes, please list, name, alive or dead & how they died. *
Veterinarian References: Name, Address & Phone # *
Personal References: Address & Phone # (If no vet references please provide two personal. Family members may NOT be used as personal references.) *
I agree to the following: All statements made on this application are truthful; I have made no false statement with regard to family members in household, references provided - not being family members, status of my home ownership and any other statements made on this application.

Thank you for your interest in adopting a PAWS dog!

Your request may take as long as 48 hours. Thank you for your patience.

PAWS New England