Michigan Animal Shelter Rescue Network
MyHumaneSociety.com

"Connecting People and Pets - for the Benefit of Both"

Sample On-line Application


Note: All on-line forms are completely customizable -

contact information or questions can be added, deleted or changed at any time per your request.

Your Rescue or Shelter Name

Address

City, State, Zip

Phone: 555-555-5555

Email: sample@youremail.com


FOR ADOPTIONS -- PLEASE FILL OUT AND SUBMIT THE ON-LINE APPLICATION BELOW



Which Pet are you Applying for?
(Your shelter name here) is located in (City, State). Are you willing to drive that far to meet and possibly adopt your new pet?
Applicant's Name:
Partner/Spouse Name:
Home Address:
City, State, Zip:
County:
Home Phone:
Cell Phone:
Partner/Spouse Cell Phone:
Email:
Employer:
Occupation:
Employer Address:
Employer City, State, Zip:
Work Phone:
How many hours per week do you work on average?
Partner/Spouse Employer:
Partner/Spouse Occupation:
Partner/Spouse Employer Address:
Partner/Spouse Employer City, State, Zip:
Partner/Spouse Work Phone:
How many hours per week does your partner/spouse work on average?
How many hours per week on average will your pet be home alone?
Do you rent or own your home?

Whose name is the mortgage or rental lease agreement in?


If rent, please list your landlord's name and phone number?
Please list the names AND ages of ALL people residing at your home - adults and children:
If you decided later to add children to your family, would you still want to keep the pet you are applying for today?
Do you run a home daycare business?
If your pet is ever exposed to children - of any age - will you take extra care to observe and supervise, at great length, to make sure pet is compatible with each child and each child is respectful of pet?
Does anyone in your home have pet allergies?
Has anyone residing at your home ever been charged with any form of animal cruelty, animal hoarding, or animal fighting? If yes, was there a conviction?
Have you discussed adopting a new pet with your immediate and extended family? If yes, were there any reservations or objections on their part?
If applying for a "bully breed" - i.e. American Pit Bull Terrier, Staffordshire Bull Terrier, Bull Terrier, English Bull Dog, etc. - is your family completely comfortable with the breed of dog you have selected?
Have you called your county animal control agency to see if there are any breed bans in your area or any restrictions in effect?
If there are restrictions, what are they?
Are you able to manage your daily schedule to emotionally, mentally, and physically provide for a pet's constant needs and demands?
Are you able and willing to change your lifestyle, if necessary, to provide for a pet's constant needs?
What do you like about the pet you are applying for?
What is the ideal personality and physical characteristics or traits that you are specifically looking for in your new pet?
What experience do you have with the breed of pet you are applying for?
Do you live in a city or country setting?
Do you live in a mobile home park?
Do you have a fenced in yard? If yes, please list height, type, length and width of your fenced area - If no, how will you secure your pet outside?
Do you currently have pets or have you owned pets in the last five years? If yes, please list type, breed, name, sex, age of each pet and if spayed, neutered or used for breeding (or have that option):
Do you still have each pet? If no, which pet(s) do you no longer have and why do you no longer own them?
Name of Vet Clinic AND years of service?
Current Vet City, State:
Current Vet Phone:
Previous Veterinarian AND years of service?
Previous Vet City, State:
Previous Vet Phone:
If applying for a dog, are you familiar with heartworm disease and how it is transmitted?
Are you willing and able to afford yearly vaccines along with an annual tests and monthly preventative medications?
Do you prefer a spayed/neutered pet or an unaltered pet that can potentially be used for breeding?
If applying for a dog, do you prefer a dog with cropped ears and/or tail or with full ears and/or tail?
If applying for a cat, do you prefer a cat declawed just in front, all four declawed, or not declawed at all?
If applying for a dog or cat, do you prefer an indoor or outdoor pet?
If your pet will be kept outside most of the time, what type of shelter do you have set up for the pet?
What forms of discipline and training will you use to correct problem behaviors exhibited by your new pet?
Some pets may need training to make them an enjoyable companion and family member, are you willing to make the time and able to afford a class(es) for you and your new pet?
Do you consider yourself a kind and patient person?
Do you consider yourself a very responsible person?
Are you willing and prepared to take on all the responsibilities - including inherent risks - of owning a pet?
Are you familiar with crate training? How do you feel about crate training a new dog or puppy?
How will you regularly exercise your pet?
Where will you keep your pet while you are not home?
Where will your pet sleep at night?
Where will your pet stay when you go on vacation?
If a situation arose that you had to move, what would happen to the adopted pet?
Under what circumstances would you give up the adopted pet or relinquish your current pet(s)?
Personal Reference 1:
Relationship to you:
Reference 1 Address, City, State:
Reference 1 Phone:
Personal Reference 2:
Relationship to you:
Reference 2 Address, City State:
Reference 2 Phone:
Have you applied for a pet and been denied by another shelter or rescue? If yes, please tell us why the adoption fell through or you were turned away:
Note: We do work with applicants other rescues may have turned away for various reasons; such as not having a fenced yard, apartment dwellers, partner orientation, age, family origin of ethnicity, etc.
BY SUMMITTING THIS APPLICATION, YOU CERTIFY THAT ALL INFORMATION GIVEN IS COMPLETE, TRUE, AND ACCURATE TO THE BEST OF YOUR ABILITY. YOU AUTHORIZE AND RELEASE FROM ALL LIABILITY WITHOUT RESERVATION, (YOUR SHELTER NAME) AND ANY PERSON GATHERING OR FURNISHING INFORMATION REGARDING THIS ADOPTION APPLICATION. Do you certify this application?
Additional Comments:

Note: Forms or other documents can be added here for easy access and download.

Adoption Application
Adoption Contract
Owner Surrender Form
Shelter Policies
Spay/Neuter Form
Website Builder