First Name*
Last Name*
Address*
City*
State/Province*
Zip/Postal Code* -
Email*
Home Phone
Work Phone x
Cell Phone*
Alt Email
Text/Pager Email
Which animal are you interested in Choose an animal: Audrey Austin Bailey Bananarama Barney Bear Bob Bridget Brock Bruzar Clover Corey Cypress Darby Dean Dempsey Dorsey Dublin Duke Duncan Dwight Eloise Enya Fiona Fitzgerald Fiyero Flynn Frenchy Glinda Helga Higgins Howie Huxley Jennie Jimmy Josie Lily Vacation Foster Needed 4/19-4/21 Lox Lucky Penny Lulu Lydia Deetz Magnolia Marigold Matzo McGregor Melo Memphis Millie Miss Lady Moon Mulligan Nala Oakley Peggy Lee Phantom Ranger Remedy Rissa Rocket Ryder Sandy Shafer Stanley Taylor Thelma Todd Valerie Velma Walter Yuri Zack Ziggy Pawdust
Please provide: Full name and age (including yourself) of anyone who resides in your home, include birth month and year for all adults (only ages of minor children). *
List at least one reference who is not a family member (name and phone number please):*
Are you interested in any other dogs? If so, please list the name(s): Or, are there other breeds that interest you? Please list:
Please list all other pets in the home: Specify Breed, Name and Age*
Are your pets current on vaccines?*
Are your pets spayed or neutered?*
What is your veterinarian clinic name and phone number with the most current records?*
Dwelling type?* Choose one: Single Family Duplex Apartment Townhouse Condominium Mobile Home Military Housing
Do you own or rent your home?* Choose one: Rent Own
Length of time in current residence?*
If you rent or live in an association, please enter the homeowner/landlord/association name and phone number:*
How many hours are you away from the home on a typical day?*
Where will the animal be kept when he/she is home alone?*
Do you have an enclosed fenced area?* Choose one: Yes No
If so, what type?
How do you intend on exercising your pet?*
Are you willing to take him/her through obedience?*
We want to be sure that you find the very perfect match! In order to help us help you, please tell us what you are seeking in a dog:*
What issues do you believe you are not able to deal with and would cause you to return a pet?*
Are you prepared for an adjustment period?*
What are the best times to reach you by phone? And what is your preferred method of contact? Email, phone or text?*
Have you applied with any other rescue Choose one: Yes No
How did you hear about us?* Choose one: Friend Subaru Petfinder AdoptaPet Previous Adopter Previous Foster Word of Mouth Event Google Facebook Instagram Twitter Other
Anything else you think we should know?
I certify that the information entered on this application is true. I acknowledge that dogs & cats are animals and will behave differently than people in their responses to human actions and changes in environment and that the behavior of an animal can be unpredictable. By submitting this application, you agree to release MARS from any liability regarding accidents, damage or behavior the pet may display. MARS relies on information provided by shelter staff, veterinary reports, previous owners, foster homes, trainers, etc. We can only share that information with you and cannot predict what behavior the animal might display. MARS does it's best educated guess as to the breed(s) but it is just that, a guess. MARS makes no breed guarantee. Enter your name and date:*
