First Name*
Last Name*
Address*
City*
State/Province*
Zip/Postal Code* -
Email*
Home Phone*
Cell Phone
Which Animal are you interested in?* Choose an animal: Chase Gracie Grundy Hattie Johnny Junior Rosie Zola
If unsure or not currently available, please describe what you are looking for?
Please list all people in your home. Include Name, Age and Relationship*
Name of Employer: Do you work FullTime or Part Time:*
Has everyone in the home agreed to adopt/foster a dog or cat? If someone does not please elaborate.*
Do you Own or Rent Your home? If you rent, enter your landlord's name and phone number:*
What type of home do you live in?* Choose one: Apartment Duplex Other Single Family House Townhouse
Do you have a fenced in yard? If yes, please include fence type and height.*
Do you have a pool or Jacuzzi/spa? If yes, how is it guarded? Is there a separate fence, deck, ladder, or cover around it?*
Do you live in a high traffic area?*
Who will be the main caregiver?
Does anyone in your household have allergies? If so, what kind?
If you are interested in adopting/fostering a puppy what is your plan for providing mid-day potty breaks?
Please list all current Pets? Age? Sex? Neutered? Type/Breed? How do they get along with other animals? How many years have you had them?*
Please list all previous pets and age? Why do you no longer have them?*
Who is your current Veterinarian? List there phone number and any previous/relevant vets if you use multiple vets? Please contact them and give permission for a refence check to be done. *
Where will the animal be kept when you ARE home? Where will they be kept when you are NOT home?*
Where will the animal sleep?*
How many hours will the dog or cat be left alone during the day*
How will you exercise the dog/cat? (Walk, Run, Hike, Bike, Backyard Play, Toys?) Who will be responsible?*
Why do you want to adopt/foster a dog or cat?*
Please describe your experience with the type of animal you are applying for. Including the length of time you have been working with dogs/cats. If you have worked with other rescues please list the group and include when. Please include any training experience you have and any experience you have with behavioral issues*
How much do you think it will cost on a yearly basis to care for your new adopted dog or cat?*
If you are applying to adopt/foster a bully breed have you ever owned/fostered a bully breed before? Describe?
Are your current pets spayed or neutered* Choose one: Yes No
4 Paws Sake, PA has a strong policy on spaying and neutering. Having your pets altered indicates that you are aware of the tragic over-population issue. If you have a special circumstance on why your animals are not altered, please write a short explanation here:
Do you use Flea/Tick Prevention?* Choose one: Yes No
Any Additional Comments?*
