Molly's Mutts and Meows

Please read this DOG application, fill in the blanks and click the submit button to send it to Molly’s Mutts & Meows. The information you provide in this application and during our interview will help us find a good match for you.

Your name:
Name of dog/cat interested in adopting (if applicable):
Spouse / partner / roomate:
Address:
City:
State:
Zip:
Home phone:
Your occupation:
Hours:
Email Address:
Are you over 21?	Yes No
Please list 2 personal references and their relationship to you:
Reference One Name:
Relationship:
Phone:
Address:
Reference Two Name:
Relationship:
Phone:
Address:
Your Veterinarian:
Name:
Address:
City:
State:
Zip:
Phone:
Please describe the kind of dog you are interested in adopting:
Age:
Sex:	Male Female
Reason For Sex Preference:
Breed/Mix:
Size:
Coloring:
Temperament:
Will it be a working dog?	Yes No
Why do you want a dog?
Can you commit to care for the dog for its whole life?	Yes No
Why do you like the breed/mix you are interested in?
Have you owned this breed/mix before?	Yes No
If the dog you want to adopt is not yet sterilized, you agree it must be sterilized either before or shortly after you adopt it. Please check this box to agree.
Your Dogs
How many dogs do you have?	1 2 3 4 5 6 7 8 9 10 none
Breed/Mix
Ages
If none, have you owned any dogs in the last 10 years?	Yes No
What happened to them?
Were any bought from a (Select all that apply)	Breeder From a store Adopted from a shelter Inherited Found stray Other
Do your dogs have any physical problems?
Any behavior problems?
Any dominance problems?
Do they get along with other dogs?	Yes No
Are they sterilized?	Yes No
Your Children
Do you have children?	Yes No
Number	1 2 3 4 5 6 7 8 9 10 none
Ages
Have they had dogs?	Yes No
Was it sucessful?	Yes No
Your Cats
How many cats do you have?	1 2 3 4 5 6 7 8 9 10 none
Ages
Any behavior problems?
Do they get along with dogs?	Yes No
Are they declawed?	Yes No
Are they sterilized?	Yes No
Other Pets
Describe
Your Home
Number of Adults	1 2 3 4 5 6 7 8 9 10
Do you own or rent?	Own Rent
If you rent, do you have written permission from your landlord to have a dog?	Yes No
Landlord Name
Landlord Phone #
Is it a:	Townhouse Duplex Apartment Mobile Home Single House Other
Yard Size
Is it fenced?	Yes No
Height
Do you have a pool?	Yes No
Is it fenced?	Yes No
How will your new dog spend its days? (While holding down your ctrl button select all that apply.)	Indoors Crated Basement Garage Porch Locked in Room Fenced Yard Loose Unfenced Tied Outside Dog House Kennel Run Other
How will your new dog spend its nights? (While holding down your ctrl button select all that apply.)	Indoors Crated Basement Garage Porch Locked in Room Fenced Yard Loose Unfenced Tied Outside Dog House Kennel Run Your Bedroom Kitchen Other
Is there anything else you would like to tell us? We love to know about you as it helps us place our animals in loving, forever homes. Feel free to give us your life story!:
By clicking the submit button you agree to allow us to visit your home by appointment as part of our application process. You also are aware that there is an adoption donation required as part of the adoption of this animal. 100% of the money goes right back into helping us save another mutt or meow in need. Applicant Information: All of the information I/we provided in this application is true and correct. If any of the information changes, I/we will advise you promtly.