Adoption Application Please fill out the form below to adopt your new best friend! First Name *Last Name *Date of Birth *Tap/click on the year to changeEmail *Primary Phone *Secondary Phone Address *Address Line 1Address Line 2CityState / Province / RegionZip / Postal CodePlace of Employment Work Phone Name of the dog you are interested in: *Do you currently live in a: House ApartmentCondoOtherHow long have you lived at your current residence? If you are not the property owner, we will need to verify your landlord's current pet policy.Landlord's full name Landlord's Phone # How many adults live in your home? How many children? What are their ages? Does anyone in your household have allergies? Who will primarily be responsible for this dog? Which of the following best describes your reasons for wanting this dog? CompanionSearch & rescueGuard dogAgilityHuntingJoggingObedience trainingWalking buddyCouch warmerHow many hours will the dog be alone each day? Where will the dog be kept when no one is home? Where will the dog be kept at night? Do you have a fenced in yard? What type? How high? If you have other pets, are their vaccinations current? Are they currently licensed? Do you have a regular veterinarian? Veterinarian Name Veterinarian Phone # Under what circumstances would you NOT keep this dog? Please list all of the pets you have had in the last 7 years including current pets and those you no longer own:Species Breed Age Sex Altered? Owned how long? What happened? Species Breed Age Sex Altered? Owned how long? What happened? Species Breed Age Sex Altered? Owned how long? What happened? Species Breed Age Sex Altered? Owned how long? What happened? Species Breed Age Sex Altered? Owned how long? What happened? Please describe the temperament and activity level you are looking for in a dog: High energyOutdoorsy dogLap dog MellowAffectionateQuietGuard dogWhen it comes to relating to dogs, I tend to be more: Strict, demanding (dog must learn and follow all commands)Moderate (encouraging of good behavior)Lenient, wishy-washy, easily coerced by the dogThe noise/activity in my home is usually: High MediumLowI would enjoy brushing/grooming my dog: RarelyOccasionallyDailyWeeklyMonthlyI would prefer a dog that: Would enjoy walking with me on a leashWill exercise him/herself in our yardWould enjoy going to the dog parkWould run, jog or hike with me Requires only enough exercise to do his/her businessMy ideal dog would: Bad dog habits that I cannot tolerate are: Please initial the following:I understand and agree that 2 Mutts Love, Inc. makes no express or implied warranty, representation or promise to the age, health, breed, habits, disposition or safety of the animal. I hereby accept the animal as is, assume all risks and responsibilities associated with the ownership of the animal, including bites, and I hereby fully and completely release, indemnify and hold harmless 2 Mutts Love, inc,. its directors, officers, volunteers, servants, and employees from any claim cause of action or liability of any sort or nature, whether know or unknown, directly or indirectly arising out of or in connection with the adoption, care or ownership, maintenance, temperament or condition of the animal. Initial I agree in the case I cannot keep the animal, he/she will be returned to 2 Mutts Love, Inc. All monies deposited with 2 Mutts Love will be considered a donation to the rescue and are non-refundable. Initial I acknowledge falsification of the above can result in my being denied adoption of an animal or if animal has been adopted to me, the return of that animal to 2 Mutts Love, Inc. Initial I certify that the above information is true and correct to the best of my knowledgeinitial Printed Name Today's Date Signature Submit