Adoption Application – Marshall's Dog Rescue

Dog you're interested in adopting*

Contact Information

Name*

First Last

Address

City*

Province*

Postal Code*

How Long at this Address?*

Best Time To Call?*

Daytime Phone*

Evening Phone*

Email Address*

Family & Housing

Besides you, how many adults are in your household?*

What is their relationship to you?

What are their relationships to you?

How many children under 18?*

What is their age?

What are their ages?

What type of home do you live in?*

Please Explain

Please Describe Your Household?*

Please Explain

Do you own or rent?*

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

Landlord's Name

Landlord's Phone Number

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

Please Explain

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

Please Explain

Do you have time to provide adequate love and attention?*

Please Explain

Other Pets

How many dogs do you have in your household?*

Dog #1

Name

Breed

Age

Sex

Spayed/neutered?

Why not spayed/neutered?

Up to date with shots?

Why not up to date with shots?

Dog #2

Name

Breed

Age

Sex

Spayed/neutered?

Why not spayed/neutered?

Up to date with shots?

Why not up to date with shots?

Dog #3

Name

Breed

Age

Sex

Spayed/neutered?

Why not spayed/neutered?

Up to date with shots?

Why not up to date with shots?

Dog #4

Name

Breed

Age

Sex

Spayed/neutered?

Why not spayed/neutered?

Up to date with shots?

Why not up to date with shots?

Do you have any other dogs in your household?

Please Explain

How many cats do you have in your household?*

Cat #1

Name

Breed

Age

Sex

Cat #2

Name

Breed

Age

Sex

Cat #3

Name

Breed

Age

Sex

Cat #4

Name

Breed

Age

Sex

Do you have any other cats in your household?

Please Explain

Do you have any other pets in your household not disclosed above?*

Please Explain

Have you ever surrendered a pet?*

Please Explain

Have you ever had a pet euthanized?*

Please Explain

Have you ever lost a pet to an accident?*

Please Explain

How do you discipline your pets and why?*

Veterinarian

Do you have a regular veterinarian?*

Veterinarian’s name

Clinic name

Clinic address

Clinic phone

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.

Please Explain

About the Dog You Wish to Adopt

What is your idea of an ideal dog and why?*

Desired age (check all that apply)*

Baby (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 sex*

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 these

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?*

Please Explain

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

Please Explain

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?*

Please Explain

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

Please Explain

Would you be interested in fostering?*

Personal References

Please list two people who are familiar with both you and your pet(s).

Reference #1 (no family members)

Name*

Phone*

Relationship*

Reference #2 (no family members)

Name*

Phone*

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.