First Name*

Last Name*

Email*

Address:*

City:*

State:*

Zip Code:*

Home Phone:

Cell Phone:

Work Phone:

Are you 21 years of age or older?*
Choose one: Yes No

Maiden name or other name you go by:

What is your and/or your spouse's occupation?*

Are you a service or veteran (with proof of honorable discharge) member of the US military or first-responder? *
Choose one: Yes No

Is this pet a gift?*
Choose one: Yes No

If yes, explain:

Provide the names and phone numbers of two personal references (at least one non-family member) who can speak to how you treat pets: *

Do you own your residence? *
Choose one: Yes No

If no, provide contact NAME/COMPANY and PHONE for your landlord:

Length of time at current address: *

Do you live in a:*
Choose one: Single-family House Duplex/Multi-family House Mobile Home Apartment Condo/Town-home Other

Do you have a fenced yard? (Answer if applying for a dog.): *
Choose one: Yes No

If yes, describe fence (height, type, etc.):*

List ALL people in your home, including regularly visiting grandchildren/children/etc. Include: Name, Age, Resident or Visitor, and if s/he suffers from pet allergies:*

List the NAME, species/breed, age and sex of all current pets:*

How many pets have you previously owned in the past 7 years (indicate species, name, and history/why they are no longer with you, e.g. passed away, rehomed, etc.)?*

Provide the NAME and PHONE number of your current or most recently used veterinarian (for those with departed pets):*

Are your pets spayed/neutered and up to date on vaccinations as recommended by your veterinarian?*
Choose one: Yes No N/A

Is your pet kept on flea/tick/heartworm prevention as recommended by your veterinarian?*
Choose one: Yes No N/A

Do your pets primarily live indoors or outdoors?*
Choose one: Inside Only Outside Only Inside and Outside

Who will care for your pets if you are out of town?*

Describe a typical day for your future pet. Include how many hours s/he will be alone, the type of exercise s/he will get, where s/he will stay when you aren't home, etc.:*

Describe the qualities that are important to you in a new pet (such as age, breed, sex, housebroken/litter trained, crate trained, declawed, active, independent, couch-potato, cuddly, social, good with kids/cats/dogs, etc.):*

Describe how you would handle a situation in which your new pet chews/claws furniture or shows signs of other destructive behavior:*

Describe any behaviors that you would be unwilling to work with (such as housebreaking/litter training, crate training, scratching, chewing, social anxiety, separation anxiety, animal to animal aggression, etc.):*

Which pet are you primarily interested in adopting?
Choose an animal: Aegon Bambi Bellatrix Boston (Senior - Special Needs) Buck Cashmere Chance (aka Woofer!) Chiffon Puppy Clover Coco SPECIAL OPTION Cork *Declawed*@ Montrose Petsmart!! Coupe Courtesy Post "Sweet Nala" Daisy Dani California Dreama Dude Flop (FIV+) Garnet Puppy Genesis Hatchback Hawaii Hearth Holly/ SPECIAL OPTION Hummus Jasper Puppy Josie @ Montrose Petsmart Jugs *special needs* Kitten Ginko Lilo Lucinda Matcha Mel Mini Fridge Nakia Naomi - ADOPTION PENDING Oreo the Chewennie puppy Petey Phillip the Cat Revere Santana Scantron Shade (SPECIAL DIET) Stache Teen Kitten Chrissy Teen Kitten Donut Teen Kitten Lure Thomas Topaz @ Montrose Petsmart Topaz Puppy Trucker Velvet Puppy Venmo - Polydactyl Walt Waylon Wiggles Winifred "Winnie" Zevyn

If you are interested in additional available pets or a certain type of animal, describe below:

Are you a previous Paws and Prayers adopter?*
Choose one: Yes No

If so, when did you adopt and whom did you adopt?

How did you hear about Paws and Prayers? *
Choose one: Petfinder/AdoptAPet Social Media Family/Friend Word of Mouth Adoption Event Other

Additional comments or information you'd like us to know:

BY SUBMITTING THIS APPLICATION, you, as a potential adopter, agree to the following:

I certify that the information I am submitting in this form is true and that any false information may result in the nullification of my ability to adopt; I understand that submission of this application does not guarantee the ability to adopt. I agree that a Paws and Prayers representative may make a home check as they see necessary, that I will take any adopted pet from Paws and Prayers to a veterinarian within the first 30 days of adoption (and regularly thereafter) and that I will assume any financial responsibility immediately upon adoption.

ONLY CLICK SUBMIT ONCE.  If you do not see a success message after  submitting your application, please scroll to the top of the page for any  error messages about your application.