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: *Marigold Alberto Amelia Angelina Arnie Bananarama Barney Bear Bella Bellamy Billie Jean Blaze Bluff Bobby McGee Bolero Brock Brynlee Brynn Cameron Cecily Chicken Leg Clyde Cookie Dempsey Dwight Eight-Ball Forrest Friday Gates Gazoo Gilligan Gwen Hanna Helga Herbie Hinkley Holly Jackson Jake Joe Judy Lou Juicy Kevin Lacey Lager Louise Matzo Mazie Meg Melo Memphis Millie Minnow Mittens Mobley Mochi Monday Nyx Pearl Peggy Poppy Preston Radagast Randy Rhino Rolly Rubble Rumba Salem Saturday Sequoia Shine Shyla Simon Skippy Sunday Sylvester Tally Thorsten Thursday Trudy Valerie Wilma Zenna
What are the best times to reach you by phone? And what is your preferred method of contact? Email, phone or text?*
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). *
Will the animal be kept inside or outside Choose one: Inside Only Outside Only Inside and Outside
When you are home, where will the animal be kept?
Where will the animal be kept when he/she is home alone?*
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 or live in an association, please enter the homeowner/landlord/association name and phone number:*
Length of time in current residence?*
Please list all other pets in the home: Specify Breed, Name and Age*
Are your pets current on vaccines?*
Is your pet spayed/neutered?
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:*
