Each ADOPTION APPLICATION is reviewed for suitability. All placements are at the discretion of Meade Canine Rescue Foundation (MCRF). Applicants must be 18 years of age. By submitting this application, you give permission for MCRF to confirm the information provided. If your application is approved, you must sign a waiver that releases MCRF of all liability.

The Dog's name you are applying for

Name of Applicant *

First

Last

Age of Applicant

Email *

Date

Address *

Address Line 1

Address Line 2

City

AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Cell Phone

Home Phone

Number of adults in household

Number of children in household

Ages of children in household

How often do children visit ?OftenOcassionallyNever

list the pets in your current household – Pet #1

PET #1 Dog or Cat ? /Breed/ Name/ Age/ Sex/ Altered ?/ How long owned ?

list the pets in your current household – Pet #2

PET #2 Dog or Cat ? /Breed/ Name/ Age/ Sex/ Altered ?/ How long owned ?

list the pets in your current household – Pet #3

PET #3 Dog or Cat ? /Breed/ Name/ Age/ Sex/ Altered ?/ How long owned ?

list the pets in your current household – Pet #4

PET #4 Dog or Cat ? /Breed/ Name/ Age/ Sex/ Altered ?/ How long owned ?

Do you live in an apartment, a condo, or a single family home?

• Apartment
• Condo
• Single Family Home

If you rent, do you have permission from your landlord to have pets on the property?

• Yes
• No

If you rent, what is the name and phone number of your landlord?

Do you have a covered patio and/or shaded area for pets?

• Yes
• No

Do you have a fence yard and/or doggie door to a fenced area?

• Yes
• No

What is the activity level in your home?

• Busy – visits from friends/family, meetings, children, parties at home
• Noisy – television, stereo, machinery, tools, kids playing
• Moderate – normal comings and goings
• Quiet – home bodies, few guests, no children

Have you ever adopted a dog before? If so, date of adoption and agency:

What qualities are you looking for in a dog?

Have you ever owned the breed/mix you are applying for?

Who will be the primary caretaker?

Please describe your work schedule:

Will someone be home during the day?

How many hours per day will the dog be alone?

Where will the dog stay when alone?

Where will the dog stay during the night?

Under what circumstances might you decide NOT to keep a pet? (Please select all that apply)

• New job
• New baby
• Moving
• Divorce
• Illness
• Allergies
• Problems with pet’s health
• Problems with pet’s behavior

Have you ever been in a situation where you were not able to keep a pet? If so, please explain. What did you do with the pet?

Are you aware that a rescue dog may not be fully housetrained?

• Yes
• No

Are you willing and able to housetrain?

• Yes
• No

Are you in a position to assume the financial commitment a dog requires, including unexpected illness and medical emergencies?

• Yes
• No

Please provide contact information for your current veterinarian.

Please list two personal references and state their relationship to you.

Personal Reference #1

personal reference #1 – Name/ Phone/ Relationship

Personal Reference #2

personal reference #2 – Name/ Phone/ Relationship

Thank You !!!

Submit