Rescue Family Profile Adoption Application

   
   
   
   
   
If at current residence for less than a year:
   


   


   


   


   
   
   

Names and relation of other adults in the household:


Names and ages of children living or visiting on a regular basis in the household:


Other pets owned (breed, age and sex of each):


Are your animals neutered and/or spayed?      Yes       No   
If not, why not?


Do you (choose those that apply)   own   rent   house     apartment     condo

How long have you lived at the present address? 


Do you have a fenced yard?   Yes       No 


Describe the type of fencing, including height:



Approximately how large is your yard? 

Where will you keep the Mastiff during the day when you are home? 

While you are away during the day? 

Where will the Mastiff sleep at night? 

How will the Mastiff be cared for on overnight absences or while on vacation?


How much time will you be able to spend with the Mastiff daily? 

Who will be the main care giver? 

Are all family members gone during the day (work/school)?   Yes       No    Approximate hours? 

Have you ever owned a dog?   Yes       No       When? 

What happened to it?  


Have you ever owned a Mastiff?    Yes       No   

If so, what happened to it? 


How many dogs can you legally have where you live?   Is there a leash law?   Yes       No 


What made you choose the Mastiff breed?  



What made you decide to adopt a Mastiff from a Rescue Organization?


Are you prepared for the financial responsibility of owning a Mastiff?   Yes       No 

What do you think it costs per month to feed and care for your Mastiff? 

Would you be willing to pay for transportation costs or to travel a reasonable distance to help bring a Mastiff from another state?    Yes       No 

Are you interested in giving foster care to a Mastiff while awaiting the Mastiff of your choice?    Yes       No 

(Foster families may be given priority in adopting the Mastiff in their care).
Name, address and phone of you Veterinarian:


Name, address and phone of another reference (preferably one that is familiar with your care of animals):


Do you prefer a   male       female       Age preference 

Any other information you feel is important in helping us determine the best match in a Mastiff for you and your family?


If you learned about the Mastiff from books, we strongly suggest that you let us know so we can put you in contact with someone in your area or tell you about upcoming shows so you can see the Mastiff up close and personal.

Please note that there will be an adoption fee set by the rescue organization that you will be adopting from.

I certify that the above information is true and I understand that prior to the placement of a Mastiff in my home the above information will be verified. I also agree to a personal interview with an MCOA volunteer, if requested, to determine the suitability of my facilities to care for a Mastiff. I understand that a home visit will be done prior to my being able to adopt a Mastiff thru MCOA Rescue.


Print Name:____________________________ Signature:______________________ Date___________  
 
Print Name:____________________________ Signature:______________________ Date___________

                       
Coordinator comments/date: _____________________________________________

Code #: ___________________________________

 

PLEASE COPY & SAVE AND/OR PRINT THIS FORM BEFORE SENDING DATA IN CASE THE FORM DOES NOT GO THROUGH. IF YOU RECEIVE AN ERROR MESSAGE WHEN SUBMITTING YOU CAN JUST EMAILTHE FORM TO THE WEBMASTER BELOW WITHOUT FILLING IT OUT AGAIN.

If you have not heard back from anyone within two weeks of sending this form email the webmaster at millcreekx@mchsi.com

 If you receive an error message or the form does not go through for you please email the copied form to the webmaster millcreekx@mchsi.com