Diane Williams/Tanya Kowalczyk

Americas Freedom Paws

Diane Williams/Tanya Kowalczyk

602-308-9503/480-228-0192

DONATIONS by PAYPAL:

DONATIONS to our vet: Sun Valley 623-512-4673, call and add to our account

Thank you for choosing us and our pets…

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APPLICATION FOR ADOPTION

Date: / Name of animal desired: / Color(s):
Age desired: / Oldest animal considered: / Approx. weight as
an adult :

Applicant Information

Name:
Address:
City: / State: / Zip:
Telephone numbers: Home: / Work: / Cell:
E-mail Address: / Date of Birth:
Number of People in Household: / If children are in the household, please list ages:
Are you or any member of your family allergic to pets: YesNo
Are you presently: Employed If yes: Employer: / Unemployed Retired Student

Co-Applicant Information

Name: / Relationship:
Telephone numbers: Home: / Work: / Cell:
E-mail Address: / Date of Birth:
Are you presently: Employed If yes: Employer: / Unemployed Retired Student

General Information

Type of residence: HouseApartment Condo Mobile Home Other
If rental, are dogs allowed?:YesNo / Size Restrictions?YesNo / Max. Size:
Complex name/address:
Manager/Landlord: / Phone number:
Where will dog live?Inside onlyOutside onlyMostly insideMostly outside
Where will the dog spend nights?InsideOutside
Do you have a fenced yard?YesNo / If Yes, how high?
Do you have a pool?YesNo / If Yes, is it gated or fenced in?
How many hours per day will the dog be alone? / Where will the dog stay when left alone?
Describe the activity level in your home: / Busy (visits by friends, meetings, children, parties at home)
Noisy (TV, stereo, machinery, tools, children playing, dogs barking)
Moderate (Normal comings and goings)
Quiet (homebodies, few guests)
Other (specify)
In the absence of the primary caregiver, who will care for the dog?
Under what circumstances would you return the dog to us? New Job Divorce New Baby Move Illness Other – specify

Are you willing to take responsibility if this pet acquires an illness? YesNo

Are you willing and able to pay the veterinary costs of caring for your new pet? Yes No

Are you willing to take the time to work with an animal on housebreaking or chewing, if such problems arise? Yes No

How much time are you prepared to allow for your new pet to adjust to your home?

Pet Information

Have you had pets in the last five years? Yes No / If yes, complete the following chart
Name of Pet; Type of Pet / Years Owned / Spayed/Neutered / Inside/Outside / Where is Pet Now?
Current or past vet name of clinic: / Phone:

Personal References

Name: / Relationship:
Phone: / Best time to contact:
Comments:

*Please understand that this is a binding contract. IF AT SOME TIME YOU ARE NOT able to take care of your dog, you MUST surrender it back to AFP rescue. If we cannot take it that day, you will be required to hold it for 2 weeks while we find a safe home for the pet to go.

Initial ______Date______