Application to Adopt

Please name the dog for which you are applying: *

Applicant’s Name * First Last

Age of Applicant and DOB *

Co Applicant’s Name and Relationship to Applicant

Other - please specify *

Total number of people currently living in the household and ages. Please provide first and last name of all adults living in the home. *

If you rent, landlord’s name and number? *Landlord will be contacted to verify permission to own.

How long have you lived at current address? *

If you have lived at this residence for less than a year, please provide your previous address.

Email *

Applicant’s occupation? *

Co Applicant’s occupation?

Please explain your work schedule (days/hours/work from home) *

On average, how many hours will the dog be left unsupervised? *

Please list two personal references (email and number) One reference needs to not be related. Reference #1 *

Reference #2 *

Is anyone in the home allergic to pets? Fearful of pets? Please explain: *

Do you currently own any pets? Please list ( name/animal/age) *

Other than current pets, have you owned any pets in the last five years? What happened to them?

Is your yard fenced in? Physical or Electric? *This is not a requirement for our adoptable dogs. *

Current Veterinarian's Practice (Name, City, State, Phone Number) PLEASE CONTACT YOUR VET TO GIVE THEM PERMISSION TO SPEAK WITH US

If you've been with your current vet for less than a year, please provide former Veterinarian Practice (Name, City, State, Phone Number)

Have you ever adopted a dog from a rescue before? Was it a good experience? *

Who will have primary responsibility for caring and training the dog? *

How much time will the dog spend outside? Will any of it be unsupervised? *

Other - please specify *

What type of circumstances, personal or related to a dog’s behavior, might cause you to surrender a dog? *

Where will the dog sleep? *

Other - please specify *

Please share your experience with training a dog?

Tell us what behaviors you find unacceptable and tell us how you'd discipline/train those behaviors.

Please tell us about how you plan on exercising your dog:

What would you do with your pet if you moved? *

How did you hear about Motley Mutts Rescue? *

Please read before submitting

By submitting this application, you certify that all information contained within this application is true and accurate. You understand that it is solely an application and does not guarantee that a dog will be adopted to you. By submitting this application, you give MMR permission to contact any references that have been given by you and MMR reserves the right to approve or deny your application for any reason that MMR deems appropriate. Any false information that is provided in this application constitutes reason for denial of your application to adopt any dog from MMR. By submitting this application, you give MMR permission to contact your landlord, veterinarian, and personal references (as applicable) to verify the relevant information in order to approve the adoption of any dog.

Please Note:

Our emails will come from motleyrescue@gmail.com. Make sure to add this to your safe addresses or keep an eye on your SPAM/JUNK mail.

Wufoo

Please read before submitting

Please Note: