Adoption Application

Contact Information

What dog you are interested in adopting?

First Name

Last Name

Email

Street address

City

Postal Code

How long have you lived at this address?

Phone Number

Best time to call

Household Information

Besides you, how many adults are in your household?

Are there children in the household?

What are their ages?

What type of home do you live in?

Do you own or rent?

By providing the below information you are allowing Marshall’s Dog Rescue to contact your landlord. Please inform them of this call so they will speak with us.

I agree to Marshall's contacting my landlord.

Landlord's name

Landlord's phone number

Please Describe Your Household?

Feel free to add details about your household

Does anyone in the family have a known allergy to dogs?

Please provide details

Is everyone in agreement with the decision to adopt a dog?

Please provide details

Do you have time to provide adequate love and attention?

Please provide details

Current Pets Information

Do you currently have any pets in your household?

Details of your pets

Have you ever surrendered a pet?

Please provide details

Have you ever had a pet euthanized?

Please provide details

Have you ever lost a pet to an accident?

Please provide details

How do you discipline your pets and why?

Veterinarian Information

Do you have a regular veterinarian?

Veterinarian’s name

Clinic name

Clinic address

Clinic phone number

By providing Marshall’s Dog Rescue with this information you are allowing Marshall’s Dog Rescue to call your vet. Please call your vet and ask them to authorize the release of information to Marshall’s Dog Rescue.

I agree to Marshall's contacting the vet clinic named above

Adoption Preferences

What is your idea of an ideal dog and why?

Desired age (check all that apply)

Puppy (8 weeks to 1 year)

Young (1 year to 3 Years)

Adult (3 years to 7 years)

Senior (7+)

Desired size (check all that apply)

Small (0-25 lbs)

Medium (25-50 lbs)

Large (50-75 lbs)

Giant (75+ lbs)

Desired breed(s)

Breed(s) you would not adopt

Desired gender

Willing to adopt (check all that apply)*

Outgoing/hyper dog

Shy dog

Dog that needs regular medication

Dog that needs training

Dog that needs grooming

None of the above

Where will the dog spend the day? (check all that apply)

Crated

Inside

Outside

Where will the dog spend the night? (check all that apply)

Crated

Inside

Outside

Number of hours daily (average) dog will spend alone?

Who will have primary responsibility for this dog's daily care?

Who will have financial responsibility for this dog?

Do you agree to provide regular health care by a licensed veterinarian?

Do you agree to keep the dog as an indoor dog?

When the dog goes out, how do you plan to supervise it? (check all that apply)

Fenced Yard

On Leash

Off Leash

Do you agree to contact Marshall's Dog Rescue if you can no longer keep this dog?

Are you willing to let a representative of Marshall's Dog Rescue visit your home by appointment before adoption?

Would you be interested in fostering?

Personal References

Please list two people who are familiar with both you and your pet(s) and are not family members.

Reference #1

Name

Phone number

Relationship

Reference #2

Name

Phone number

Relationship

Agreement

All of the information I have given is true and complete. This dog will reside in my home as a pet. I will provide it with quality dog food, plenty of fresh water, indoor shelter, affection, annual physical examination and vaccinations under the supervision of a licensed veterinarian.

I agree

Adoption Application

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