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.): (if no fence, enter "N/A")*

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 Arbor Baby Fern Baja Blast Bellatrix at Montrose Petsmart! Bits *Special Needs* Boston (Senior - Special Needs) Bristol Bruce Buck Bucky - PENDING Bumper at Montrose Petsmart Burgess Chili Coco SPECIAL OPTION Courtesy Post "Sweet Nala" Courtesy Post: Petey Coutesy Post: Jake Dani California Dreama Dude Dude and Dreama Flop (FIV+) Garmin Genesis Glenneth Grace (Virtue Litter) Harper Hawaii Holly/ SPECIAL OPTION Huggable Hank!! Josie Joss Jugs *special needs* Kittens Altoid & Mentos Koopa at Montrose Petsmart! Lil Timber Lucinda Matcha Mellow Memo Midas Mini Puppy/pending adoption Mints Miss Wiggles Moss Phillip the Cat Piglet Pocket Puppy Puppy Evo Puppy Presley Raul Reggae Revere Sadie Salsa Santana Shade (SPECIAL DIET) Sheila Spicy Posh Spice Spicy Sporty Spice Sweet Clover Tanner Teen Kitten Deli *one eye* Thomas Toby - PENDING ADOPTION Topaz Puppy Torte Tundra *Special needs* Valor (Virtue Litter) Walt 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.