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Adoption Application Form
In order to adopt a dog from SXM PAWS you must be 18 years old and have the consent of all people living in the house. SXM PAWS reserves the right to refuse this application.
Name(s):
*
Email Address:
*
Telephone:
*
First
Last
Address:
*
Address Line 1
Address Line 2
City
State / Province / Region
Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia (Plurinational State of)
Bonaire, Saint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Congo (Democratic Republic of the)
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (Kingdom of)
Ethiopia
Falkland Islands (Malvinas)
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran (Islamic Republic of)
Iraq
Ireland (Republic of)
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea (Democratic People's Republic of)
Korea (Republic of)
Kosovo
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia (Federated States of)
Moldova (Republic of)
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia (Republic of)
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine (State of)
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin (French part)
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten (Dutch part)
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syrian Arab Republic
Taiwan, Republic of China
Tajikistan
Tanzania (United Republic of)
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
Uganda
Ukraine
United Arab Emirates
United Kingdom of Great Britain and Northern Ireland
United States Minor Outlying Islands
United States of America
Uruguay
Uzbekistan
Vanuatu
Vatican City State
Venezuela (Bolivarian Republic of)
Vietnam
Virgin Islands (British)
Virgin Islands (U.S.)
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Name and description of the animal in question.
*
Are you a home owner?
*
Yes
No
Do you have a fenced yard? If not, how do you plan to exercise your dog daily?
*
What is the number of people in the house?
*
Relationship
*
Ages of the children in home, if any?
*
List all previous and current pets: species, age, spayed/neutered, indoor/outdoor, and where are they now?
*
Will the dog be kept indoors or outside?
*
Indoors
Outside
Will the dog be limited to certain areas of the house? If yes, where will they be allowed?
*
How many hours per day will the dog be left alone?
*
Will you crate the dog? If yes, how many hours per day will the dog be in the crate?
*
Why do you want a dog?
*
References
For your consideration, please provide two personal references and your current veterinarian (if you currently have one).
Name of Personal Reference #1:
*
Email Address:
*
Telephone:
*
Name of Personal Reference #2:
*
Email Address:
*
Telephone:
*
Name of Veterinarian:
Email Address:
Telephone:
Agreement
By signing this application, I certify that the information I have given is true. I understand that SXM PAWS reserves the right to deny this application for any reason and I authorize investigation of all statements in this application.
Do you have a vet that you use? If yes, please provide the vet’s name and phone number.
*
I do commit to treating my dog in St. Maarten/St. Martin or home state/country for monthly heartworm prevention and monthly flea/tick medications plus yearly vaccinations
*
I agree
I do agree to SXM PAWS to sterilize male/female dog at 6 months IF the animal is adopted before such sterilization occurs.
I agree
I agree to pay the US adoption fee.
*
I agree
I do agree to SXM PAWS having the right to check on the pet within the first 6 months of adoption. If pet is in any discomfort or distress, SXM PAWS has the right to take back the pet and cancel this agreement. No refunds will be given. (copy)
*
I agree
By signing this application, I certify that the information I have given is true. I understand that SXM PAWS reserves the right to deny this application for any reason. I authorize investigation of all statements in this application.
*
I agree
Date
*
Signature of Adoptee
*
Clear Signature
Signature of SXM Paws Representative
Clear Signature
Name
Submit
Address
2 Tray Drive
Cay Bay Road
St. Maarten
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