Please copy the form below into an email addressed to glasschnauzers@aol.com and to schnauzer@dslextreme.com, complete the requested information, and then send the email. (To copy the form, select the text, hit CTRL-C [Command-C on a Mac], then put cursor into the text window of a new email message form and hit CTRL-V [Command-V on a Mac] to paste the form into the e-mail window.)
MSCNC Adoption Application
Today's Date: _____________________________________________
You and Your Family
Your Name: _______________________________________________
Your Occupation: __________________________________________
Spouse's Name: ___________________________________________
Spouse's Occupation: ______________________________________
Street Address: ___________________________________________
City, State & Zip Code: _____________________________________
E-Mail Address: ___________________________________________
Work Phone: _____________________________________________
Home Phone: _____________________________________________
Cell Phone: _______________________________________________
Do you have children? Yes __ No __
If so, number and ages: ____________________________________
Pet(s) You Wish To Adopt
Name(s): __________________________________________________________________________
Yes __ No __
Preferences (sex, age, activity level): ___________________________________________________
Who is the pet for? __________________________________________________________________
Are you looking for an inside pet or an outside pet? ______________________________________
Your Home
Do you live in a single family residence? ___ apartment? ___ town house? ___
Do you rent? Yes __ No __
If so, do you have your landlord's permission to have a pet? Yes __ No __
Are there any weight restrictions? Yes __ No __
What? _______________________________________________________________________________
May we contact landlord to verify? Yes __ No __
Landlord name? _______________________________________________________________________
Landlord's phone number? ______________________________________________________________
Is your yard fenced? Yes __ No __
What type of fencing? ___________________________________________________________________
How high is the fencing? _________________________________________________________________
Are the gates secure and locked? Yes __ No __
Do you have a pool? Yes __ No __
Is the pool securely fenced off from yard? Yes __ No __
Living With a Pet
Where will the pet stay during the day? ______________________________________________________
Where will the pet stay at night? ____________________________________________________________
How many hours and where will the pet be exercised? _________________________________________
_________________________________________________________________________________________
How many hours and where will the pet be left at home alone? __________________________________
Other Pets
Do you have other pets? Yes __ No __
Please describe your other pets. ____________________________________________________________
Are your current pets neutered? Yes __ No __
Have you ever surrendered a pet in the past? Yes __ No __
Why? ____________________________________________________________________________________
What happened to your prior pets? __________________________________________________________
__________________________________________________________________________________________
Professional Help
Do you currently have a veterinarian? Yes __ No __
If so, who is it? ___________________________________________________________________________
Would you be willing to call in a trainer if a problem developed that you were unable to handle on your own? Yes __ No __
Who will take care of the dog when you travel? ________________________________________________
__________________________________________________________________________________________
What would cause you to give up your pet and what would you then do with him/her? __________________________________________________________________________________________
__________________________________________________________________________________________
Other information you deem pertinent to your application: ______________________________________
__________________________________________________________________________________________
By submitting this application, I represent that the above information
I have provided is accurate, and I agree to allow MSCNC rescuers
to verify this information. MSCNC reserves the right to refuse adoption
to any applicant. This application will become part of the adoption contract.
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