Personal Information

First Name

Last Name

Address

City, State, Zip Code

Email

Phone Number

Best time and method to contact

If you do not get this dog, do you have a second choice?

Yes

No

How did you first hear about this dog and/or PAW Alliance?

Are you employed?

Full Time

Part Time

Retired

Student

Household Information

Please list the names of all person(s) who live in the household

Please list the ages for all person(s) listed above who live in the household

Does everyone in the household want a new dog?

Yes

No

Does anyone in the household have an allergy to animals?

Yes

No

Who will be responsible for taking care of the dog? (List all)

Who will care for the dog if/when you are away?

If for any reason you are no longer able to care for a NLOL dog after adoption, how would you proceed?

Trusted family member or friend who would be willing to assume care of the dog

Contact PAW Alliance so that PAW Alliance may resume responsibility of the dog

Do you own or rent?

Own

Rent

Please describe your yard

No yard

Unfenced yard

Partially fenced yard

Completely fenced yard

Please list all your current pets and include Name, Age, Breed, Gender, Altered, Owned for how long?

Are all current pets up to date on vaccines?

Yes

No

Please list your Veterinarian's Name, Animal Hospital, Address, and Phone Number

Home Enviroment

How much time will the dog spend alone in 24 hours?

Where will the dog be when someone is home?

Where will the dog be when they are alone?

Where will the dog sleep at night? (Our dogs MUST be inside at night)

If the dog is crated, how long will the dog be crated for at a time?

How much exercise do you believe the dog will need and how will you provide that exercise?

How much time and in what way will you give this dog to adjust to its new surroundings?

Socialization is important for dogs. How are you planning to socialize this dog?

Have you ever had to give a pet up after adoption?

Yes

No

Have you ever taken an animal ot Animal Control / Animal Shelter or had a pet picked up by Animal Control?

Yes

No

List two personal references (not relatives), including Name, Address, Phone number and Email

Adoption Process

If the application process continues, do you agree to have a home visit?

Yes

No

If the process continues, do you agree to meeting your dog at the prison, and if you want them, giving PAW Alliance your commitment to adopt?

Yes

No

At graduation, do you agree to pay our $350 adoption fee? (We will gladly accept an additional, optional donation, if you feel so inclined)

Yes

No

After you adopt your NLOL dog, do you agree that PAW Alliance will do at least one after adoption home visit?

Yes

No

Please add any extra comments you may have

We will contact you after having processed this application. Thank you again for your interest.

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Applicant Signature (Please type First and Last Name)

Dog Adoption Application

Personal Information

Household Information

Home Enviroment

Adoption Process