Adoption Application

Animal(s) Interested In

Full Name

Date of birth

Address

City, State and Zip Code

Phone #

Alt Phone #

Secondary Contact

What type of home do you live in (House, Apartment, Farm, etc.)

How long have you lived there

Do you plan on moving

Do you rent or own your home?

Property owner name and contact info

If you rent please give the rules regarding pets along with the landlords name and phone #. By providing this information you are giving PAHS permission to contact your landlord, please inform them of the call so they will speak with us.

Are there any children in the home?

If so how many?

Does anyone in the house have pet allergies?

Have you ever adopted from PAHS?

If yes, when?

Do you still have them?

If not, why?

Where will this pet spend most of their time?

Additional Informatioon

Please list all pets you've had over the last 5 years. (Name, Type, Gender, Age, Current Status).

PAHS reserves the right to refuse any adoption for any reason. We require ALL current animals be up to date on their rabies vaccine and spayed or neutered. If renting we will contact landlord to ensure pets are allowed and meet their guidelines. This is to help ensure we do not have animals being returned.

Are your current pets up to date on vaccines? We will ask current vet.

Please list your current vets name, clinic, and phone #.

How much do you think your animal would cost per year?

Personal Reference

Any additional comments or information you would like us to know?

Signature

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Adoption Application

Get in Touch

620-672-6777

prattareah@yahoo.com

Come See Us!

10233 Bluestem Blvd, Pratt, KS 67124, USA

Hours