Dog Adoption Application

MAHS Dog Name

Name

First

Last

Street Address

City

State

Zip Code

Email

Phone Number

Housing

Rent

Own

Live with Parents

Land Contract

Home Owner/Landlord's Name

First

Last

Home Owner/Landlord's Phone Number

How long have you lived at your current residence?

Are animals allowed in your residence?

Yes

No

Full names of all adults in the same residents:

Names and ages of all children under 18 years old in the same residence:

What type of fence do you have?

No Fence

Invisible Fence

Fenced

If fenced, what type and what is the height?

Veterinarian Reference

Veterinarian Phone Number

I allow MAHS to contact my veterinarian prior to adoption

Yes

No

Have you owned a dog before?

Yes

No

Is this dog going to be an indoor or outdoor dog?

Indoor

Outdoor

If outdoor, what type of shelter will you provide?

How long and where will the dog be left alone in the house?

Are you interested in a special needs dog?

Yes

No

Are you comfortable training your dog?

Yes

No

How will you be training your dog?

Where/How long will you exercise your dog each day?

What is your reason for adopting a dog?

How much do you think it will cost yearly to care for your dog?

Who will be primarily/financially responsible for this pet?

Are you aware/familiar with local animal laws?

Yes

No

Have you adopted an animal from a shelter in the last 5 years?

Yes

No

If you have previously adopted, from where?

List all pets you've had in the past 2 years:

Are all of your current pets spayed, neutered, and current on vaccines?

Yes

No

Do you still own the above listed pets?

Yes

No

If no, why not?