PAW PRINTS, HUMANE SOCIETY OF SEDONA, INC.
2115 SHELBY DRIVE ~ SEDONA, ARIZONA 86336
Phone (928) 282-4679 ~ Info@HumaneSocietyOfSedona.com
www.HumaneSocietyOfSedona.com

Adoption Application

CC#_____
In order to find these animals a permanent, responsible and loving home and to find the appropriate animal for you, please take a moment to complete the following:

Name_____________________________________________Phone___________________
Street Address___________________________________Mailing____________________
City__________________________________ State________________ Zip Code________
Driver's License#___________________________or other ID #_____________________
Place of Employment________________________________Phone___________________
How long have you resided at your present address?______________________________
Is this a house____ apartment____ or mobile home____?  Do you own____or rent_____?
If you rent, Landlord's Name___________________________Phone_________________
(All landlords will be called for verification of "Pets Allowed" prior to taking the pet home.)
Do you expect to be moving soon? Yes___ No___
Do you have a fenced yard?  Yes___ No___
Are there children at home? Yes___ No___ If yes, list ages_____________________________
Have you adopted pets from us before? _______ If yes, indicate what_____________________.
When did you adopt the pet(s)?____________ Pets whereabouts now?_________________
Have you any other pets at home?____________If yes, list animals_________________.
Are these pets sterilized? Yes____ No____
Have you ever brought animals to us?  Yes____ No____  If yes, when did you bring them
to us?____________________ For what reason?__________________________________
Do you want the pet for: yourself____ your children____ watch dog____
  mouser____ gift____ other________________
Will the pet be kept: inside_____ outside_____ tied_____ fenced____
At night will the pet be kept: inside_____ outside_____

According to the Arizona Revised Statutes and the City of Sedona Animal Control Laws:
(Section 6-1-4-J) No unclaimed animal shall be released for adoption without written agreement from the adopter guaranteeing that such animal will be sterilized within thirty days for adults and sixteen weeks for animals who have not yet reached puberty.

Do you agree to have the animal sterilized as stated above?   Yes____ No____ Please Initial ____
What veterinarian do you use? _______________________________________
Are you familiar with your local animal ordinances? Yes_____  No______
Did you select this animal using the internet? Yes_____  No______

Date____________          Signature____________________________________