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Adoption Application
Dog Interested in:_______________________
Today's Date: ___________________________
Pet ownership is a serious responsibility. The policy of this adoption group is to assure that
each person who adopts a pet is aware of the responsibility, and that each is capable and willing
and ready to accept that responsibility morally, physically, emotionally and financially. It is quite
true that not everyone who desires to own a pet should have a pet.
The following questionnaire has been designed to aid both you and the adoption group in deciding
if you and/or your family is indeed at this moment adequately prepared to assume the type of
responsible ownership which we are endeavoring to assure for our adoption animals.
Please be sure to answer all questions and feel free to add your own comments. If a question
does not apply write N/A.
Name:_________________________________________________________ Age: ___________
Phone: (Day) ________________ Phone: (Eve) _________________ Phone: (Cell) _________________
Email: _______________________________________________
Name of spouse/signficant other/roommate:_______________________________________________________
Address:_______________________________ City:______________________________ Zip: ___________
Your Occupation:_____________________________ Spouse Occupation: _______________________________
If this relationship were to change, with whom would the dog remain?:___________________________
Do all adults in your household know you plan to adopt a dog? Yes______ No ______
Who will be primarily responsible for the dogs care? ___________________________________________
What are your reasons for adopting a dog? A companion for you ________ Your cat/dog ______
Spouse ________ Children _________ Gift (for who?) __________ Other________
Your type of Dwelling (house,apartment,condo,mobile) ____________________ Own or Rent _________
If you rent, are dogs allowed? (Yes/No) ___________ Length of residency ____________________
Can you provide proof that your residency would allow a new dog? (Yes/No)_______________________
Does your residency have restrictions on breed, size or number of animals? (Yes/No) ________
In your selection of a dog what is your preference? Breed ________________________________
Age________ Long/Short Hair ____________ Sex _______ Temperament ______________
This dog will be: Indoor only ________ Mostly Indoor _________ Mostly Outside ___________
Outdoors only ___________ Other ______________________________________________________________
If you answered indoor only, please describe what outdoor access the pet will have
(when will it go out, etc.) _______________________________________________________________________
If you have children that live or stay with you, please list their ages: ____________________________
Please list any other adult household members:______________________________________________________
Have your children ever been around dogs? Yes_______ No ________
Do your current pets like dogs? Yes ________ No _________
Have you ever bred a dog? Yes ________ No _________
If yes,did you breed for: Fun _______ Show ______ Profit ________ Accidentally happened ______
LIST PETS YOU CURRENTLY OWN:
Type/Breed Age Spayed/Neutered? Kept Inside or Out Last Vaccination Date
(Yes/No)
_______________ _______ _______________ ________________ _________________________
_______________ _______ _______________ ________________ _________________________
_______________ _______ _______________ ________________ _________________________
LIST PAST PET HISTORY (pets you had since you were an adult and no longer own):
Type/Breed Age Spayed/Neutered? Kept Inside or Out When did you own this pet
(Yes/No) and what happened to it?
_______________ _______ _______________ ______________ _____________________________________
_______________ _______ _______________ ______________ _____________________________________
_______________ _______ _______________ _______________ _____________________________________
In regards to the above questions, what happened to your pet(s)?
Hit by car _____ Old Age ______ Died of disease _______ Gave Away______ Gave to Shelter______
(Explain) ________________________________________________________________________________________
______________________________________________________________________________________________
Other ________________________________________________________________________________________
______________________________________________________________________________________________
What outside space is available for the dog? Fenced yard ___________ Height __________
Type of Fencing? Chain Link _____________ Block Wall ________________ Wood ______________
Other ________________ Locks on gates? ______________________
Other provided living areas: Garage ___________ Balcony _________ Unfenced yard _________
Kennel Run ________________________ Other ___________________________________________________
Do you have a: Balcony ____ Pool _____ If yes, is pool secured or separately fenced? ______ Pet door _____
Will you have your dog tied up? _______________________________________________________________
Where will your dog sleep during the night: __________________________________________________
In what areas of the house will the dog be allowed? ______________________________________
How many hours per day on average will the dog be left alone?
0-4 ____ 4-6 _____6-8 __________ 8-10 ________ 10-12 ________ over 12 ______
Do you have a relative who would adopt the pet if you, for any reason, become incapable of caring
for him or her? (Note: MSFR reserves the right to approve this individual)
Yes or No, if yes who? ________________________________________________________________________
Please provide name, address and phone number: ________________________________________________
_______________________________________________________________________________________________
Who is your current or last veterinarian (name,address,phone): ________________________________
_______________________________________________________________________________________________
Will your dog be allowed on the furniture? Yes___________ No ___________
If not, how will you train your dog not to jump on your furniture? ________________________
________________________________________________________________________________________________
Would you allow an inspection of your home/yard? Yes ___________ No __________
How do you plan on housebreaking your new dog? _____________________________________________
(please understand that even dogs that are housebroken will go through an adjustment period)
Are there any reasons that might preclude you from being able to properly care for your new pet?
If yes, please list reasons: ___________________________________________________________________
__________________________________________________________________________________________
Under what conditions would you not keep your new dog?
Move to a place that didn't allow your new dog _______ Move out of state ____________
Too much hair ________ Dog grew too big ________ Chewing ________ Barking ________
Digging _________ Housebreaking problem ___________ Kids ignored pet ___________
New baby ___________ Allergy ___________ Pets didn't get along ________________
Destructive Behavior ________________ Family Changes/New Relationships ______________
Expensive Vet Bills ____________________ Other _______________________________________
If your dog develops behavioral problems, what would you do? _______________________________________
If you have a family changes such as a new baby how would you integrate your new dog? _________________
___________________________________________________________________________________________
___________________________________________________________________________________________
What would you do with your dog if you could not keep it for some reason? _____________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
Do you travel a great deal? Yes _________ No ____________
Where will your pet stay when you are on vacation? ____________________________________
Have you ever trained a dog in obedience class? Yes _________ No ____________
Will you be able to live with fur on your furniture, stains on your rugs, a warm body on your bed,
and an animal who may be destructive at times? Yes __________ No ___________
How did you hear about this pet adoption?
Internet_______ Friend______ PETCO ______ The Herald ______ Other__________________________
ADOPTIONS MAY REQUIRE A HOME CHECK FOR THE SAFETY OF THE PET. IN THE EVENT THAT MY
APPLICATION IS ACCEPTED, I AGREE AND CONSENT TO HAVE A VOLUNTEER VISIT MY HOME AT A
MUTUALLY AGREED UPON TIME. I ALSO GIVE CONSENT TO MINIATURE SCHNAUZERS AND FRIENDS RESCUE
TO CONTACT MY CURRENT OR PAST VETERINARY.
I UNDERSTAND THAT SHOULD I BE ACCEPTED TO ADOPT THIS PET THAT THIS APPLICATION
BECOMES PART OF THE ADOPTION CONTRACT.
YES ___________ NO _______________
Signature: _______________________________________________________ Date: __________________
THANK YOU FOR TAKING THE TIME TO COMPLETE THIS APPLICATION.
PLEASE NOTE: Filling out this application DOES NOT guarantee an adoption. We have thoroughly
evaluated all of the animals in our care, and try very hard to match the right dog to the right person
and situation. Adoptions are not on a first come first serve basis. We reserve the right not to adopt.
If we do not call or email you within 3-4 days of receiving your application, it means that either:
1. The dog was adopted another applicant, or
2. We felt that the situation presented on the application was not the right situation
for that particular dog.
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