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: Asanti Azalea Bananarama Basil Beckham Biggby Blossom Breezy Brita Bumbo Byron Camellia Cheddar Cindy Lou Daisy Darrin Derby Diego Fahrenheit Fiore Flora Folgers Foster Needed - Karley Giorgio Goodson Henrik Holt Hunter Hyacinth Ilo Iris Jared Jasmine Jax Jersey Lea Leda Logan Loretta Mati Meadow Murray Nora Owen Paco Pepper Plum Polo Posey Powell Primrose Pung Roboto Rose Rosie Sabrina Sally Shakespeare Shine Sigfried Sisco Smith Steve-O Taco Tobin Tulip Tully Victor Viola Virginia Wentworth Wyatt Yama Zither

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). *

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?*

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:*