Paws Crossed Animal Rescue Inc - Adoption Application
Healing hearts one paw at a time.
Full Name
*
Mr
Mrs
Miss
Ms
Dr
Prefix
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State
Post code
Please Select
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Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
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Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
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Belgium
Belize
Benin
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Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
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French Polynesia
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The Gambia
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Greenland
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Israel
Italy
Jamaica
Japan
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Kiribati
North Korea
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Laos
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Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
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Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
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Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
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Ukraine
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Uruguay
Uzbekistan
Vanuatu
Vatican City
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Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
E-mail
Phone Number
*
-
phone number
Have you ever given away a pet before for any reason? please explain
Birth Date
*
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
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31
Day
Please select a year
2024
2023
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2019
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1925
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1923
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1920
Year
Residence
*
House, own
House, rent
Unit, Own
Unit, Rent
acreage/ Property
Other
How long have you lived at you current residence?
How long to you plan to stay at this residence?
*
If you do move in the future, what are your plans for your animals?
*
List all other people living in your home.
Name
Age
Gender
1.
2.
3.
4.
5.
Is anyone in your home allergic to animals?
*
Yes
No
Name of your veterinarian or veterianry Hospital/Clinic:
*
Phone number of your veterinarian:
*
-
phone number
The animal you are interested in:
I want to adopt a
*
Small breed dog or puppy
medium to large breed dog or puppy
large to giant breed dog or puppy
Working breed.
Other
Name of specific animal you're interested in (if any):
Age of pet wanted
*
Young Puppy 2-4 months old
Adult (1-7)
Junior Puppy 5 month - 1 year old
Senior (7 +)
No Preference
Other
I prefer a
*
Male
Female
No preference
This animal needs to get along with:
*
Dogs
Cats
Kids under 5
Kids over 5
Men
Women
Other animals not listed
This animal will be
*
Companion for myself /My household
Gift for extended family
Gift for someone outside family
Business tax deduction - property protection or working dog
Other
I prefer an animal with an activity level that is:
*
Low
Medium
High
No Preference
What type of personality are you hoping for in your new pet?
What concerns , if any do you have regarding adopting this animal?
Will your pet spend any time outside? How much?
*
What food or foods do you anticipate feeding your new pet. (Suggestions available)
*
Are there any behaviors this animal could have that would be totally unacceptable to you?
Please tell us about the animals you have now.
*
Name
Species
Male or Female?
Spayed or Neutered?
Age
Notes:
1.
2.
3.
4.
5.
6.
If your existing dogs are not desexed, please tell us why:
Submit Adoption Application
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