Adoption Form

* = required field

* First Name:

* Last Name:

* Are you 18 or older? Yes No

* Do you have any children? Yes No

If so, what are their ages?

* Street Address:

* City, State, Zip:

* Email Address:

* Home/Cell Phone:

Work Phone:

* Type of Residence: Own Rent | House Apartment

Landlords Name:

Landlords Phone:

Type of companion you are seeking:
Puppy Kitten Adult Dog Adult Cat Small & Furry

Large, Medium or Small Breed:

Names of dogs/cats you are interested in:

*Do you have a fenced yard?
Yes | No

* How many hours will the pet be left alone each day?

* Have you ever surrendered a pet before? Yes No

If so, please explain:

* Do you have other pets? Yes No

If so, please provide what other pets you have:

If yes, please provide veterinarian info:

You must call your vet and provide authorization for Buffalo Paws & Claws to speak with your vet regarding your pets.

Please provide 3 references (not related to you):
* Name & Phone #:
* Name & Phone #:
* Name & Phone #:


If you have photos of your backyard (dogs only) and main living area of your home (dogs & cats), please attach them below: