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 Hattie
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?*
