Paws of Hope Initiative

Name *

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Do you currently own a pet? *

Yes

No

Do you own or rent your home? *

Own

Rent

*If renting, does your lease allow pets?

Yes

No

Are you currently receiving any government assistance? (e.g., food stamps, housing assistance, Medicaid) *

Yes

No

Do you have a plan for daily care of the pet (feeding, walking, grooming, etc.)? *

Yes

No

Do you have transportation available for vet visits and emergencies? *

Yes

No

Are you willing to participate in pet enrichment activities, such as Dog’s Mobile Gym or Donnie’s Playworld, as part of the program? *

Yes

No

What kind of pet are you looking to adopt? *

(Check all that apply):

Dog

Cat

Date

MM

DD

YYYY