Pre-Adoption Application

Pup & Cat Co.

A Humane Society

P. O. Box 1987

Winder, GA 30680

Phone: (770) 867-1622

 FAX: (404) 591-8698

www.pupandcatco.com
     

We request that you provide to us the following information so that we may better insure that the pet you wish to adopt will be best suited to you, your home & lifestyle, and also to ensure that the pet will be placed in an environment that will be most compatible with its needs. We may take several applications on an animal.  If you are approved a member of Pup & Cat Co. will contact you.

Pup & Cat Co. has the right to refuse any applicant.
Pet's Name:  

Dog



Cat



Your Name:

  

Street Address:

  

City:

 

State:

 

Zip:

 

Home Phone:

  

Work:

  

Cell:

  

Do you:

Own:  

Rent:  

Other:  

If other, explain:

  

Do you:

Work:  

Attend school:  

Other:  

If other, explain:

  

Landlord's name and phone number:

  

Do you have:

Fenced yard:  

Fenced run and/or pen:  

Dimensions:

  

Please list all pets you have had in the last five (5) years:

Breed/Type

Kept Where?

Still Own?

If no, where is it?

Spayed/Neutered?

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Where are your pets kept at home?

 

What size pet do you want?

Small:  

Medium: 

Large:  

Any size:  

  

Will the pet be:

Indoor:  

Outdoor:  

Both:  

 

 

If both, how much time inside and how much time outside?

 

 

 
 

Pup & Cat Co. Pre-Adoption Application

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Please tell us why you would like to adopt a pet.  Check all that apply.

Personal companion:  

Personal protection:  

As a gift: 

To breed:  

Watchdog:  

For a child:  

Companion for another pet:  

 

 

If companion for another pet, what type, size and age is other pet?

 

 

Do you have children?

Yes:         No:  

 

 

If yes, how many and what ages?

 

If no, do you plan to have children in the future?        Yes:         No:  

If yes, what will happen to your pets at that time?

  

 

How would you describe your household?

Busy:  

Quiet:  

Away from home a lot:  

Travel often:  

Active:  

Other:  

If other, please explain:

 

Does anyone in your household have allergies?        Yes:          No:  

Have you ever adopted from Pup & Cat Co. before?        Yes:          No:  

If yes, when and what type of pet did you adopt?

  

 

Are you familiar with the animal control laws in your area?        Yes:          No:  

Have you ever been cited for a violation of the animal control laws?        Yes:          No:  

If yes, what were the circumstances?

 

 

Will you use a leash to walk or exercise your dog?        Yes:          No:  

How many hours per day will your pet be left alone?

  

How will the pet be kept while you are away?

 

If you have a pet now, who is your veterinarian?

 

What type of heartworm preventative do you use?

 

What type of flea control do you use?

 

What will you do with your pet if you move?

 

Realizing that dogs and cats often live 15 years or longer, are you willing to take responsibility for your pet's entire life, keeping it current on yearly shots and tests?

Yes:          No:  

 

Pup & Cat Co. Pre-Adoption Application

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Are you willing to keep a dog on heartworm preventative?        Yes:          No:  

Are you willing to use effective flea control products?        Yes:          No:  

Would you be willing to allow a representative from Pup & Cat Co. to come to your home to check on your animal's well-being?        Yes:          No:  

How much do you estimate the cost of caring for a dog and/or cat is yearly?

  

Who will be responsible for the car of your new pet?

  

Will you decide to alter your pet's appearance? (De-claw, dock tail, crop ears, shave fur, etc.)  Yes:          No:  

If yes, please explain:

 

How do you feel about spaying and neutering?

 

 

Are you prepared to make a lifestyle adjustment to provide this animal a lifetime home with you?

Yes:          No:  

Does everyone in the family agree to adopt a pet?        Yes:          No:  

Under what circumstances do you think it would be wise to find a new home for a pet?

 

 

Are you willing do deal with an adjustment period and work through behavioral problems with your new pet?

Yes:          No:  

Would you be interested in making future donations to Pup & Cat Co.?        Yes:          No:  

Would you be interested in becoming a volunteer with Pup & Cat Co.?        Yes:          No:  

Would you be interested in becoming a foster family for a dog or a cat?        Yes:          No:  

 

By signing the line below, I certify that the information I have given is true and that any misrepresentation of facts may result in my losing the privilege of adopting a pet or of keeping the pet after adopting.

 

 

Signature:

   Date:  
       
       
       

Have a Heart.....Adopt a Homeless Pet

 
 
 
 
Pup & Cat Co. Pre-Adoption Application

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