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Perry’s Orphans Sanctuary @ Little Paws Rescue
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* = Mandatory Field
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Sanctuary Pet Information
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Type of Pet:
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Pet Name:
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Breed or Description:
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Pet Size:
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Pet Age:
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Pet found on our website?
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If NO, which website?
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Applicant Information
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Full Name*:
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Address Line 1*:
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Address Line 2:
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City *:
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State *:
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Zip Code:
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Phone *
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Home:
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Work:
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Cell:
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Best time to contact you?
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Email Address:
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No. of Adults in the home:
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Children in the Home: How many? Ages:
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Relationship Status:
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Spouse/Partner/Roommate agrees to adoption?
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If NO, please explain:
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Employment Information
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Employment Status:
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Employer Name:
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Employer Address:
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Employer Phone:
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No. of years at present employer?
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Permission to verify employment?
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References
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Reference Name*:
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Reference Phone*:
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Reference Email*:
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Vet Name *:
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Vet Phone *:
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Vet Email *:
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Residence Information
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Home:
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Time Lived There?
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If Renting, do you have permission to have a pet?
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If NO, Explain
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Landlord Name:
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Landlord Phone:
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Where do you live?
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Distance home is from the roadway?
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Is the property fenced?
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Type of fence:
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Fence Height:
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Fence in good repair?
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No Fence - Explanation for pet exercise and toilet.
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Swimming Pool?
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Pet Living/Care Arrangements
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Do you have other pets in your home?:
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If Yes, Explain:
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Who will be the primary caretake of this pet *:
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Can you make a lifetime commitment to this pet? *
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Someone home days? Yes No
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If NO, how many hours daily will the pet be alone?
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If NO, where will the pet be kept during the day? Be specific
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Will the pet be crated at night?
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Where will the pet stay when the family is on vacation? Please explain.
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If you move, what will you do with the pet?
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Action if the pet becomes destructive?
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Circumstances where you would not keep the pet. Please explain:
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How much time for companionship will you provide daily?
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Do you fully understand any stated health care requirements in the pet profile? (If applicable)
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Additonal Comments/Questions about the adoption guidelines/fees?
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By submitting this application to Perry’s Orphans Sanctuary I understand the lifetime commitment I am making to the selected pet of my time, financial support, providing veterinary care for him/her in sickness and in health, to protect him/her from harm, to love him/her for the remainder of his/her days on this earth. I accept and understand all/any existing health, special needs, or behavioral problems this selected pet has at this time. Should at any time in the future my circumstances change or I need to surrender the pet for any reason, I agree to return this selected pet to Perry’s Little Orphans Sanctuary.
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Date:
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