Life4Paws, Animal Rescue, Placement and Education Animal Rescue, Placement and Education
A Non-Profit Organization
(818) 584 7661
Los Angeles, California
Adoption Application Form

Please fill out the following information for us to process your application.
* indicates a required field.

Pet Details

Name of Pet:
Description of Pet:
Sex: Male Female Unknown
ID #:

Applicant Information

* First Name:
* Last Name:
Street Address:
Zip Code:
* Home Phone:
Work Phone:
* Email:

Household Information (Spouse/Room-mate/Children)

Number of persons in the household:
Number of children (under 16):
Ages of children:
Name of spouse or roommate:
Occupation of spouse or roommate:

Residence Information

How long at present address:
Do you rent or own: Rent Own
Type of residence: House   Condo   Apt   Mobile Home
Others, pls indicate:
Landlord's Name:
(If you rent)
Landlord's Phone:
(If you rent)
Type of Fence:
Highest Point:
Lowest Point:
Type of Gate:
Number of Gates:
Height of Gate:
Type of Lock: Padlock   Key Entry   Latch
Others, pls indicate:
Number of locks:
Is anyone in your household allergic to dogs:

Areas Available To The Dog

When would the dog be inside:
When would the dog be outside:
In what areas of the house would the dog be allowed:
What outside areas are available to the dog: Balcony   Kennel/Run   Covered Patio   Garage 
Others, pls indicate:
How many hours of the day would the dog be alone:
Do you have a pet door:
Where would the dog sleep at night:

Other Pertinent Information

How do you plan to provide for your dog when you are out of town:
What would you do if you had to move and had trouble finding a place that allowed pets:
What would happen to your dog if you had to relocate out of State or overseas:
Do you have experience with dog obedience training:
If yes, what experience:
Would you be willing to attend obedience classes at your own expense:
How will you discipline your dog if it misbehaves:
What would you do if the undesirable behavior continued:
Under what circumstances would you not keep your dog:
What would you do in that event:
Are you prepared for veterinary expenses such as emergency medical problems,
(especially in old age), that you will incur when adopting this dog for it?s entire life:

Have you ever bred a dog:
If yes, why:
If you own a dog or cat, is it spayed or neutered:
If not please explain why:
Do you have a veterinarian:
Name and City :
Please indicate all dogs and cats you have owned, and all pets you currently have.
Indicate the "Type", "How and Why obtained", "How long Owned" and "What Happened"
to the pets. Under the column ?What Happened? explain if the pet was lost, given away,
stolen, sold taken to an animal shelter, or died (In which case state cause of death).

Additional Information

Would you agree to an inspection of your premises:
What are your primary reasons for wanting to adopt a dog:
* What is 2 + 3?:


Any false information may result in nullifying the adoption.
Life4Paws reserves the right to refuse to adopt to any applicant for any reason.