Date
MM
DD
YYYY
Pet Name
*
Name
*
First Name
Last Name
Date of Birth
*
Drivers License Number
*
Email
*
Phone
*
(###)
###
####
Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
How did you hear about MCP?
Why are you interested in adopting a pet?
People in Household besides Adopter
Is everyone in your family on the same page wanting to learn more about this dog you're applying for?
Yes
No
Is everyone in your family ready to bring in a new family member?
Yes
No
Do you own or rent your home?
*
Housing Type
If renting, do you have landlord permission to have a pet?
Yes
No
Don't Know
If applicable, does your landlord, condo or homeowners association require a pet deposit, have size or breed restrictions, or other rules regarding pet ownership?
If yes, please explain
If renting, provide landlord name and contact phone/email
Do you have a fenced in yard? If so, briefly describe it
If not, how will you exercise the dog?
Who will have primary responsibility for this pet's daily care?
How many hours a day will the pet be alone, on average?
Where will the pet be kept when alone?
Where will the pet be kept at night?
Excluding emergency care, estimate what you plan to spend each year on this dog (vet checkups, annual vaccinations, heartworm/flea prevention, food, supplies, training, etc)
Which of the following behaviors would be a serious problem for you?
*
Select any/all that apply
How would you address these or other undesired behaviors?
*
What would cause you to return or give up this pet?
*
Select any / all that apply
What is your previous experience with dogs?
Are you familiar with decompression?
Current household pets/companion animals
If you have a dog currently:
What is a typical day for your dog?
Do you walk your dog daily?
Does your dog have canine friends? If so in what capacity? How does your dog meet other dogs? Does you dog have dog friends over in their space?
Have all your current and previous pets been spayed or neutered?
*
Yes
No
If no, please explain
Type of and date of most recent vaccinations of current pets
Veterinarian Name and Contact Info for current or previous pets
*
Have you ever surrendered a pet to another person or animal shelter?
*
Yes
No
If yes, please explain
2 Additional References:
*
Please list someone who is familiar with both you and your pets (if applicable.)
*
