Dog Adoption Application

Name of Dog or Puppy to be Adopted

Applicant Name

Co-applicant Name

Street Address

City

State

ZIP

Home Phone

Cell Phone

Applicant Email Address

Co-applicant Email Address

Applicant Occupation

Co-applicant Occupation

Please enter the type of home the applicant lives in

House

Townhouse

Condo

Apartment

Other

If renting does lease allow pets?

Yes No

If needed, do you have approval to have pet in your home?

Yes No

Members of Household

Please enter the name and age of each member of your household

Animals in Household

Enter the species, breed, age, sex, spay/neuter status, and date of last rabies vaccination for each animal in your household

Vet Clinic

Enter the name of your veterinarian

Phone

Phone number for your vet

Approximately how long, on an average day, will this puppy/dog be left alone in the home?

When home alone, where will the puppy/dog be kept?

Loose inside home

Crated inside home

In garage or basement

Outside

Do you have a completely fenced yard?

Yes No

If no, are you willing to walk/exercise the puppy/dog safely on leash?

Yes No

If fenced yard, type and height of fence

Please describe your previous experience with animals

What would you do if you could no longer keep this dog or puppy?

Adopters with other dogs in the home may need to arrange a meet and greet with this dog or puppy.

Applicants must be 18 years or older.

The pre-adoption application is not a contract or guarantee of any kind that the animal you wish to adopt will be approved.

Animals may receive multiple pre-adoption applications. We will make the best match between the dog/puppy and the adopter.

I have read the questions above. I certify my information is complete and true, and I understand that any false information may void the application. I authorize MAAC to verify the information provided. I understand that my pre-adoption application does not guarantee or reserve an animal from MAAC. I understand that MAAC reserves the right to decline my application.

Applicant Signature

Please type your whole name as your signature

Co-applicant Signature

Please type your whole name as your signature

Dog Adoption Application

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