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Application to Adopt a DOG
Full Name
Age
Email Address:
Phone Number
Full Home Address
Employer
Name and Age of Significant Other
Names and Ages of any additional family members living in your home
Do you rent or own your home? Rent
Own
If you rent, please provide the name and phone number of your landlord.
How long have you lived at your current address?
Is there a specific dog you are interested in? Yes
No
If yes, who?
Would you be interested in another if the above dog is no longer available? Yes
No
Maybe
Do you have a preference of sex? Male
Female
No Preference
Why are you looking to adopt a dog?
How many hours per day will your dog be left home alone?
Where will the dog be kept when unattended?
What specific characteristics are you seeking in a dog?
Please list any other pets currently in your home. Please include name, age, breed, and sex.
Please list the names, sex, and breed of any pets no longer living with you.
Are all of your current pets up to date on vaccinations and spayed or neutered? Yes
No
Is your current dog on Heartworm Preventative? Yes
No
Have you ever had to give away a pet? Yes
No
If yes, please describe in detail why and where the pet is now.
Do you have a fenced yard? Yes
No
Partially
If yes, what type, how tall, and how large is the area that is fenced?
Please describe how your dog will live on a daily basis. Please be detailed and include your plans for feeding and potty time.
Do you have, or will you purchase a crate if necessary? Yes
No
Maybe
Do you plan to take your dog to a professional trainer? Yes
No
If Necessary
How long do you feel is adequate to allow a dog to adjust to your home?
Explain any training or behavioral issues you feel comfortable working with.
Explain any training or behavioral issues that you CANNOT work with.
If you were to return this dog for any reason, what would it be?
Please list your current or most recent veterinarian. Include their phone number and address.
REFERENCE 1: Please list the name and phone number of someone not related to you or living in your home.
REFERENCE 2: Please list the name and phone number of someone not related to you or living in your home.
Your full name here acknowledges that submitting this application does not serve as the approval for adopting a dog. You agree to allow us to perform a homevisit, and if approved, to sign a legally binding adoption agreement.

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Application to Adopt a CAT
Name:
Email Address:
Phone Number
Full mailing address
Age
Please list the names and ages of any other people or children living in your home.
Do you rent or own your home? Rent
Own
If you rent, please provide the name and phone number of your landlord.
Why are you looking to adopt a cat?
Is there a specific cat you are interested in? Yes
No
If yes, who?
If he or she is not available, would you be interested in another? Yes
No

Would you prefer a male or female? Male
Female
No Preference
Please specify the age range that you are looking to adopt.
Please list all pets currently in your household, including name, age, breed/species.
Please list any previous pets that are no longer with you and what happened to them.
Are all of your current pets up to date on vaccines and spayed or neutered? Yes
No
Will your cat live indoors or outdoors? Indoors
Outdoors
Both
Please describe any behavioral issues that you are unable to work with.
If you were to return this cat, what reason(s) would they be?
Please provide the name and phone number of your current or most recent veterinarian.
REFERENCE 1: Please provide the name and phone number of someone not related to you and not living in your household.
REFERENCE 2: Please provide the name and phone number of someone not related to you and not living in your household.
Your full name here acknowledges that submitting this application does not serve as the approval for adopting a cat. You agree to allow us to perform a homevisit, and if approved, to sign a legally binding adoption agreement.

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Application to Foster a Dog
Name:
Email Address:
Phone Number
Mailing Address
Employer
How many hours per week do you work?
Where will the dog be kept when unattended?
Name & Age of Spouse or Significant Other
Please list any other people or children living in your home, as well as their ages.
Do you rent or own your home? Rent
Own
If you rent, please provide the name and phone number of your landlord.
Why are you looking to foster a dog?
Are you or have you fostered for other rescue organizations? Yes
No
If yes who? Please include a phone number for the organization
Would a male or female fit better in your home? Male
Female
No Preference
Do you have a fenced yard? Yes
No
Partially
If yes, please describe the type, height, and size of the fenced area.
Please describe how the foster dog will live on a typical day. Include plans for pottying and feeding.
Please list any other animals currently living in your home. Include name, age, sex and breed.
Please list any pets that are no longer with you, and where they are now.
Are all of your current dogs up to date on vaccinations, spayed or neutered, and on heartworm preventative? Yes
No
Please describe any training or behavior issues that you are comfortable working with.
Please describe any behavior or training issues that you CANNOT work with.
Are you able to transport a foster dog to the veterinarian as needed? Yes
No
Please provide the name and phone number of your current or most recent veterinarian.
REFERENCE 1: Please provide the name and phone number of someone not related to you and not living in your home.
REFERENCE 2: Please provide the name and phone number of someone not related to you and not living in your home.
Your full name typed here acknowledges that this application does not serve as an approval to foster for our organization. If the application is approved, you agree to a homevisit conducted by a PASS representative and to sign a legally binding foster contract.

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Providing hope for the homeless and hungry pets of PA.