First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

Email*

1.   Submit Pre-Adoption Application. 
2. Once approved, Foster family will contact you to meet animal. 
3. If adopter AND foster family agree, then adoption can move forward.  (If an animal has multiple applications, we sometimes turn down amazing families. Please know, this is not personal.)
4. Home visit.
5. Adoption.  

  *COMPLETE ALL REQUIRED FIELDS ON THE APPLICATION 

(incomplete applications will be rejected)  

Best way to contact you?(Check All That Apply)

Best Phone Number to contact you?*

What is the name of the animal you are interested in?*
Choose an animal: Abbee Anzo and Anik Aries and Kratos Bailey Becky Bella Big Mama Biggie Bob Boggee Brownie & Toffee * 1/2 off Sale* Bubbles & Chipper Buttercup Cal-Calley Caramelo Chalupa 1/2 off SALE Cheerio 1/2 off SALE Cinderella Cindy-*1/2 off adoption fee* Coal Crouton Cupcake & Gracie Dexter and Squeekie Dio and Latte Edith Everette and Marlin Flash Frank 1/2 off SALE Freya Freya Faye Jack Black Karl Kiki (must be adopted with Q-Tip and Q-Tip) Kyleigh *1/2 off Sale* Kyrah Lamb Chop 1/2 off SALE Layla Blair Lexy Lou Lillie Anne Loki Lola Lee Luanne Lucy Gean Marley Meadow and Willow Midnight & Solo Mike & Mindy Mistletoe Myers Noelle Oreo Oreo Peach Penny & Ginny *1/2 off sale* Perri Piglet and Paulo Puma Q-Tip (must be adopted with Kiki and Kiki) Red 1/2 off SALE Rudy 1/2 off SALE Scotch and Neo Scrump Shade Sigmund Smalls Smoke (must be adopted with Walter and Walter) Sophie Sox Stella Tabee Tator Tot & ShiTeah Theodore and Big Bubba Trixy & Scrappy Turkey, Poppy and Penelope Walter (must be adopted with Smoke and Smoke) Willow Winnie Zelda, Tula and Penelope

List any other animals you would also like to be considered for:

Have you ever adopted from MSAR?*
Choose one: Yes No

If yes, please provide the Name of animal(s), type of animal(s), and approximate date(s) of adoption: (Enter N/A if this does not apply)*

Are all adults in the home ready for a new pet?*
Choose one: Yes No Still working on it

Applicant: Full Name *

Applicant: Date of birth*

Applicant: Occupation*

Secondary Applicant: Full Name

Secondary Applicant: Date of birth

Secondary Applicant: Occupation

Please list Full Name, Date of Birth and Occupation of any other adults in the home that are not listed above:

Please list any Maiden names and/or alias names for any household members.

Any violent criminal history for ANYONE living in the household? *
Choose one: Yes No

If yes, please explain:

DISQUALIFICATIONS INCLUDE:  INVOLVEMENT OR CHARGES WITH CRIMES, OFFENSES OR A CRIMINAL HISTORY AT ANY LEVEL INDICATIVE OF ANY VIOLENT OFFENSES, ANIMAL ABUSE/NEGLECT, CHILD ABUSE/NEGLECT, ABUSE/NEGLECT OF A VULNERABLE ADULT, ANY SEXUAL OFFENSES, ASSULT, THEFT, ARSON, OFFENSES INVOLVING DRUGS, NARCOTICS, CONTROLLED SUBSTANCES, ROBBERY, BURGLARY,  KIDNAPPING,  DOMESTIC VIOLENCE AND OTHER CHARGES OR INVOLVEMENT WITH CRIMES THAT WE FIND CONCERNING. ALL DENIALS WILL REMAIN AT THE DIRECT DISCRETION OF MSAR STAFF.

How many children living in the residence? *

Ages of Children in Residence (Check All That Apply):

Any known or suspected allergies and or health concerns with household members that would inhibit contact and or the ability to provide care or for a pet?*
Choose one: Yes No Possible

If Yes, Please Describe:

On average, how many hours will the animal be left alone per week?

Any anticipated work, hour and our location changes in the future?
Choose one: Yes No Possible

If Yes, please explain:

Describe your or your family's overall average activity level and include favorite hobbies? *

Housing*
Choose one: Own Rent

How long have you lived at your current residence?*

Are there any anticipated plans on relocating in the future? *
Choose one: Yes No Possible

Housing Type
Choose one: Apartment Condo Duplex Farm House Mobile Home Town Home Other

If Mobile Home/Trailer: Is your mobile home within a community/park that you provide lot rent?
Choose one: Yes No Does Not Apply

If Yes, please provide the Mobile Home Park's information in the landlord section of this form.

Rental Policy

• Only rental appropriate animals will be considered for adoptive placement within rental property or living situation when applicant is not the property owner.
• Residence must allow pets & accept the pet applied for. Rental Policies will be verified. EXCEPTION: must verify medical reason exists to allow the pet, as stated by treating physician.
• No bully, large, working, herding, guardian, type dogs will be permitted.
• Restrictions: Some animals have restrictions specific to each animal despite breed. Please check animal information first, in case restrictions apply.

Submitting pre-adoption application acknowledges that you accept and have been informed of our Rental Policy. 

Landlord Name (Type N/A if does not apply)*

Landlord's Email Address:

Landlord Phone Number (Type N/A if does not apply)*

Are you aware of the Animal Policies in place by your Landlord? (Ex: Is there a deposit required or monthly fee?) Describe:

Are there any restrictions in place by your Landlord? (Ex: limit to number of animals, weight limit, restrictions on species or breed) Describe:

Do you currently have any pets? Check all that apply.

Please list the Name, Breed, and age of all resident pets living in your care: (Type N/A if not applicable)*

Are all of your pets spayed/neutered?*
Choose one: Yes No Does Not Apply

Are all of your pets up-to date rabies and routine vaccinations?*
Choose one: Yes No Does Not Apply

If No, please explain:

Date of last vet visit and/or vaccinations: (Type N/A if this does not apply)*

Previous resident pets have left my home due to:

Please provide your 5 year pet history include: Name, type, age, and why they left your home (death, re-homed etc…) (Type N/A if not applicable)*

IMPORTANT

If your resident pet is not UTD on vaccinations, rabies or altered, we cannot process your application without a vet verified medical reason. Please give your vet clinic permission to speak with MSAR or we cannot process your application.

Not sure if your pet is current?  Please contact your vet to check. Incomplete applications will be denied and you will need to reapply once your resident pets are current with all vetting. 

Name of your current veterinary clinic that has up to date information about your pet? (If you do not have a vet please list one you intend to use):*

Vet's Phone Number: (Required field: If no vet, please enter NA)*

Vet's Address:

List any other vets your pet has seen:

Please list any other person that your pet's vet record might be listed under:

What age of pet best suits your and your family's energy level, hobbies and lifestyle? (Check All That Apply)

Preference to Male vs. Female?
Choose one: Male Female Doesn't Matter

Do you intend to declaw your cat /or kitten once adopted?*
Choose one: Yes No Unsure Does Not Apply

What traits are you looking for, best suited for your lifestyle and most appealing to you in a pet?

Where will the animal be while you're home?*

Where will the animal be while you're sleeping?

Where will the animal be while you're not home?*

Comments:

How did you hear about us?

I Certify That the Above Information is True and Accurate and I Have Read the Disclosure Above: (enter name for signature)*