Applicant Name *

First Name

Last Name

Co-applicant name (if applicable)

If you are adopting with a spouse, partner, or significant other, please provide their name

First Name

Last Name

Primary Phone Number *

Please provide the best number to contact you

(###)

###

####

Alternate Phone Number

(###)

###

####

How did you hear about us? *

Adoptapet.com

Facebook

Family or friend

Instagram

Event

Petfinder.com

Other

Applicant Employment Status *

Employed (full-time or part-time)

Self-employed

Student

Homemaker

Retired

Unemployed

Other

Length of Employment (if applicable)

Less than 6 months

6 months to 1 year

1 - 5 years

5 - 10 years

More than 10 years

Applicant Address *

Please provide the address of your primary residence (where the dog will be living)

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Primary Residence *

Single-family home

Townhouse

Apartment / Condo

Mobile Home

Owned or Rented? *

Owned, by you and/or your partner

Owned, by someone else in the house

Rented

Other

If renting, is your name on the lease?

Yes

No

If renting, do you have your landlord's permission to have a dog?

Yes

No

Landlord Name (if applicable)

Please indicate your landlord's name or the name of the property management company from which you rent

First Name

Last Name

Landlord Phone Number (if applicable)

(###)

###

####

Are there children / teens under the age of 18 living at your residence? *

Yes

No

Does anyone living at your residence have allergies to animals? *

Yes

No

Does your residence have a fully fenced yard? *

Yes

No

Do you have any current pets? *

Yes

No

Veterinarian Name *

Please provide your current or planned veterinarian's name

First Name

Last Name

Veterinarian Phone Number *

(###)

###

####

What is your dog ownership experience? *

Please indicate which of the following best describes your experience with owning a dog

I currently have or have had dogs of my own as an adult

I grew up with dogs or have worked with dogs, but have not owned one as an adult

I have always wanted a dog, but never owned a dog

Other

Have you ever been denied an animal foster? *

Yes

No

Do you plan to crate your foster dog when you are away from home? *

Yes

No

Unsure

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, including 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 Mama Zoey & Puppies Rescue, I am free to re-apply and undergo the application process in the future.

I agree

I disagree

E-Signature *

By writing your name, you certify that the information provided on this application is true and accurate

First Name

Last Name

Date *

MM

DD

YYYY