First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
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Email*

Home Phone

Work Phone
x

Cell Phone

Alt Email

Text/Pager Email

Which animal are you interested in
Choose an animal: Badger Blackberry Bravo Byron Caicos Carrie Contessa Pupstar Daisy Diamond (must be adopted with Jade) Flora Goodson Hazel Herc (must be adopted with Tbone and Tbone) Horatio Hugo Inxs Jade (must be adopted with Diamond) Jamos Janet Jimin Judd Juniper Kitana Kool Moe Lara Lionel Mabel MS. Pac-Man Nyla Opal Peaches Ragetti Raymond Rosie Roza -Special Needs Seymour Sheena Sherman Sonny Springsteen Tbone (must be adopted with Herc and Herc) Tekken Valley Vita Vixie

What are the best times to reach you by phone? And what is your preferred method of contact? Email, phone or text?*

Full name and age (including yourself) of anyone who resides in your home. Please include birth month and year for all adults (only ages of minor children). *

How many hours are you away from the home on a typical day?*

How much time will the animal spend alone during the day

Will the animal be kept inside or outside
Choose one: Inside Only Outside Only Inside and Outside

Where will the animal be kept when you are home

Where will the animal be kept when he/she is home alone?*

Where will the animal sleep

Where will this pet eat?

What traits are you looking for in a pet

For cats only: Are you planning to declaw?
Choose one: Yes No

What is your veterinarian clinic name and phone number with the most current records?*

Have you applied with any other rescue
Choose one: Yes No

Have you ever given up a pet? If yes, please explain

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

If you rent, have you received the approval of your landlord to have an animal
Choose one: Yes No

If you rent or live in an association, please enter the homeowner/landlord/association name and phone number:*

Do you live where there is an Association?
Choose one: Yes No

If you have an association, what are their requirements regarding pets?

Are you aware of your city's pet ordinances?(please explain)

Length of time in current residence?*

Any future moving plans?

Does anyone in your house have allergies? (explain)

Are you only interested in fostering a specific animal? If yes who?

Please list all other pets in the home: Specify Breed, Name and Age*

Are your pets current on vaccines?*

Is your pet spayed/neutered?

Why are you interested in adopting a pet at this time

Please describe your typical day:

Please list any previous pets:

Where are these pets now?

What do you enjoy most about a cat?

What do you least enjoy about having a cat?

What draws you to this particular cat?

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?*

List at least one reference who is not a family member (name and phone number please):*

How did you hear about us

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:*