Adoption Application Form

Thank you for your interest in adopting one of our dogs! Please fill out the form below and we will be in touch with you shortly!

Note: We do our best to honor applications on a first come, first serve basis. Once a rescue member contacts you regarding your application, we ask that you respond within 2 days, otherwise the next applicant will be contacted.

Enter the name of the dog(s) you are considering adopting and would like to meet.
Applicant Information
Applicant Name *
Applicant Name
Please provide your name.
Co-applicant name, if applicable
Co-applicant name, if applicable
If adopting with a spouse, partner or significant other, please provide his/her name.
Applicant Address *
Applicant Address
Please provide the address of your primary residence. (Where the dog will be living.)
Primary Phone Number *
Primary Phone Number
Please provide your best contact number.
Alternative Phone Number
Alternative Phone Number
If you have an alternative phone number, please list it below.
How did you hear about us? *
Applicant Employment Status *
Please indicate your employment status.
If you indicated an employment status of Other, please explain.
If employed, please indicate your employer.
Length of Employment, if applicable
If employed, please indicate how long you have held your current employment.
Household Information
Please indicate which best describes your primary residence.
Please indicate the ownership or rental status of your primary residence.
If you indicated an ownership or rental status of Other, please explain.
If renting, is your name on the lease?
If renting, do you have your landlord's permission to have a dog?
Please make sure to consider any breed or weight restrictions your landlord may require.
Landlord or Property Management Company Name, if applicable
Landlord or Property Management Company Name, if applicable
Please indicate your landlord's name or the name of the property management company from which you rent.
Landlord or Property Management Company Phone Number, if applicable
Landlord or Property Management Company Phone Number, if applicable
Please indicate your landlord's phone # or the phone # of the property management company from which you rent. Mama Zoey & Puppies Rescue will contact this individual or company to confirm lease agreement regarding dogs.
Please indicate the number of people that reside in the home where the dog will live.
Are there children or teens under the age of 18 living at your residence? *
If indicate how many children or teens under the age of 18 live at your residence.
Please provide the age(s) of all children and teens under the age of 18 in your household.
Does anyone living at your residence have allergies to animals? *
If you indicated a member of your household has allergies to animals, please explain.
Does your residence have a fully fenced yard? *
Please indicate whether or not your residence has a fenced yard.
Do you have any current pets? *
Please indicate if you have any current pets. You do not need to consider any fish or reptiles permanently confined to an aquarium/terrarium.
Please include name, species, breed, age, and spay/neuter status
Please provide your veterinarian office's name, city location and phone number. If this will be your first pet and you have not yet established a veterinarian, we recommend that you select one as soon as possible.
Dog Details
What is your dog ownership experience? *
Please indicate which of the following best describes your experience with owning a dog.
If you selected an ownership experience of Other, please explain.
Have you ever been denied an animal adoption? *
Please indicate whether or not you have been denied the ability to adopt an animal by another rescue, shelter or animal control.
If you indicated that you have been denied an animal adoption, plesae explain
Please provide details regarding why you and your family has decided to adopt a dog.
Please indicate the qualities and characteristics of your family's ideal dog. Feel free to indicate all details such as age, gender, breed, energy level, behavioral traits, etc.
Please describe what you believe are the most important aspects of owning a dog.
Please provide your plan for addressing any behavioral problems that may arise after your new dog comes home.
It is expected that puppies will require house training and may have accidents until fully trained. However, you may not have been aware that changing an adult dog's environment may cause accidents and the need for a house training refresher.
Please indicate all ways that you will ensure your dog receives exercise.
Please indicate the average number of hours the dog may be left at home alone.
Do you plan to crate your dog when you are away from home? *
Whether it is for house training, separation anxiety, etc., it might be necessary to crate your new dogs while you are away. Please indicate whether or not you are planning to crate your dog when you are not home.
Acknowledgements
Please indicate your agreement to the below acknowledgements. *
I have read the above questions and information carefully and have filled out this application honestly. I understand that omission of information and/or failure to answer all questions and sign the application may result in the application being denied. If an omission or untruth is discovered after an adoption takes place, I understand that the Mama Zoey and Puppies Rescue reserves the right to annul the adoption and reclaim the animal. I understand that the above questions and information are an application to be considered for a dog's adoption and does not guarantee I can adopt the dog(s) in which I am interested. I understand that I will be required to complete an Adoption Contract and pay the applicable adoption fee before an adoption is considered final. I give Mama Zoey & Puppies Rescue permission to fully investigate the information provided on this application, include but not limited to a landlord or veterinarian. I understand that Mama Zoey & Puppies will conduct a home visit, as well as a meet & greet with the other pets in my household, on a mutually agreed upon date before an adoption decision is made. I understand that the ability to adopt a dog is dependent on many factors, including but not limited to the compatibility of the family and home with the individual dog and other applications received for the dog(s) in which I am interested. I understand and agree that it is Mama Zoey & Puppies Rescue's prerogative, when multiple applications for the same dog are received, to decide which home is most appropriate and that their decision is final, and therefore will respect that decision. I understand that, unless otherwise indicated by the Mama Zoey & Puppies Rescue, I am free to apply and undergo the application process in the future.
E-Signature *
E-Signature
By writing your name, you certify that the information provided on this application is true and accurate.
Date *
Date
Date of application