First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

Email*

Home Phone

Work Phone
x

Cell Phone

Alt Email

Which animal are you applying for?*
Choose an animal: Aspen Butters Cosmo Rocket Ember Maks Pre Adoption Pumba Zippy

What are your thoughts about pets on furniture?*

We require a home visit prior to any adoption. Is this acceptable to you? Yes No

If you do not work outside your home, please explain how you will support this pet?

Please provide an approximation of the full cost for the care of this dog, including routine medical care, food, toys, grooming, training?*

Approximately how many hours per day and how many days per week will this pet be left alone?*

Who will be the primary caretaker of the pet? Please let us know your age group i.e. 18-29, 30-40, 40-49, 50-59, etc.

Do any children live in your home or visit frequently? If so, please provide their names and ages.*

Who in the household will care for the pet*

Are you willing to install or upgrade your fence if needed?*

Would you ever give a pet up? If yes, under what circumstnces and where would it go?*

When left alone, where will this pet be kept: inside, outside, crate, daycare, etc.?*

What type of home do you reside in? (ie. single family, condo, apartment, duplex, etc.) *

Do you have a yard? yes or no Is it fenced? yes or no If yes, what type of fencing? (ie. chainlink, split rail with wiring, stockade, electric, etc.) How high is the fence? (ie. 4ft., 5 ft., 6 ft., etc.) *

Please list all of the people that reside in your home and their relationship to you.*

How will you exercise if applying for a dog? IE on lead, off lead, free run, fenced yard, fenced dog park, unfenced dog park?*

Where will the pet spend the majority of his/her time when you are home?*

Do you rent or own? If you rent, YOU MUST PROVIDE YOUR LANDLORD'S/MANAGEMENT COMPANY'S CONTACT INFORMATION for verifiction of permission to allow the pet to live in the home and written confirmation of permission is required. If you own, we may ask for verification.*

If you do not have a fence, explain how you will handle bathroom time and exercise?

When do you not have your dog on leash?

Where will this pet sleep at night?*

Do you have any pets at this time? If so, please list each pet, their name, age, breed and indicate if they are spayed/neutered, up-to-date on vaccinations, taking heartworm preventatives and flea/tick protection.*

Please decribe your relationship with your pet(s) and kindly be as detailed as possible.*

Have you ever given away an animal? If yes, please describe in detail what were the circumstances and where did he/she go?*

What would you do if your pet escaped from your yard/care? Please describe.*

Please provide the name and phone number of your veterinarian or vet hospital, and the name(s) under which the pet(s)' files are registered under.*

Medical emergencies can occur and can be quite costly. How would you handle this situation?*

What would you do if your pet(s) required medical care and you could not afford to pay for it? (no right or wrong answer )*

Please list all pet(s) you have had in the past and what became of them:*

Have you and your family discussed the responsibility, cost, time and effort that a new pet requires?*

Do you or any members of your household suffer from allergies and/or asthma?*

Do you foresee yourself adopting additional pets? If so, what kind? What is the maximum number of pets you intend to have at one time?*

What would become of your pet(s) if you had to move, especially out of state?*

Have you ever bred a dog, cat or some other pet? If so, please give details:*

What traits are you looking for in your new pet? Ie. playful, protective, active, couch potato, etc.*

Do you travel for business and/or vacation? If so, who will care for this pet when you are away?*

Under what circumstances or behaviors might cause you to return this pet back to our rescue? (Please note: It is part of our adoption contract that if you cannot keep this pet for ANY reason, you MUST return the pet to us.) *

What type(s) of behavior the pet may exhibit would you find difficult to live with?*

Would you consider adopting a pet with a handicap, short term health issues, long term health issues, or a senior pet?*

What other requirements are you looking for in a new pet? Ie: good with dogs/cats, toddlers, housetrained, crate trained, etc.*

Do you intend to give someone the pet you have applied to adopt, as a gift? *

Are you willing to give this pet enough time (some take 30 days or more) to adapt to his/her new environment and family members? Yes No*

An adoption fee is required for , which helps with the cost of the dog's complete care (vetting, food, toys, bedding, etc.) while with our non-profit rescue. If price is not listed on the application page you can contact rescue for adoption fee. Is this acceptable to you? Yes No

If you have any comments and/or wish to tell us more about you and your family, please use this space.

Does the county, town, or municipality in which you live have any breed restrictions? If so please explain.*

If you are applying for a puppy or an untrained dog, are you prepared to housetrain? What housetraining method(s) will you use? What will you do if he/she has an accident?*

Some dogs may require additional training. Would you be willing to enroll in dog training classes with your new dog?*

Will you crate train ? Yes No
Choose all that apply: Yes No

Please list three personal (non-family) references, include day and evening phone numbers for each reference and an email address for each: 1. 2. 3. *

What type of back-up plan do you have in the event you can no longer care for this pet? (ie. hospitalization, nursing home, deployment, death, etc.)*

Our policy is to microchip the pet and register in AMMF name. This is not transferable We do this because we have numerous resources and experience to help find your lost pet. Please click yes to agree

Have you applied to adopt a dog with any other rescue? If so, how far are you in the application process? (ie. submitted application, phone interview, home visit, etc.)
Choose all that apply: Yes No

What is your State Id or Driver License number? (A copy of your ID or license will be required at the time of the home visit.) *

How did you hear about us? *

Would you in the future be willing to volunteer for us . If yes in what ways? EX Fostering, events, home visit check, transporting etc.

Would you like to receive our newsletter via email.*
Choose one: Yes______ No _______