MLRR On-line Adoption Application


Before completing this application, please be aware of the following:


Applicant Name
Work phone
Applicant work hours
Co-Applicant Name
Work phone
Co-Applicant work hours
Home Phone
Address
City
State
Zip code
Applicant e-mail address
Do you own or rent?
Type of Home
How long have you lived at this address?
Describe your ideal dog (ie. temperament, activity level, etc.)

Type of Lab Requested

Sex
Color No preferenceBlack ChocolateYellow
Age range
How long are you willing to wait for the best match?

HOME ENVIRONMENT

Other household residents (besides applicant)
Name Age Relationship
Primary person responsible for the Lab
Estimated cost to care for a dog for one year
Is anyone in your house allergic to animals?
If yes, please explain
Is your yard completely fenced?
If yes, type of fence
Height of fence
If no, how will you contain the dog to your property?
How many hours per day will the dog be alone?
Where will the dog be when no one is home?
Where will the dog be at night?
How many hours will the dog be outside alone?
Do you plan to allow the dog off leash in an unfenced area?
If yes, explain

TRAINING

Are you willing to crate train the dog, if necessary?
Where will you take your dog for training? (REQUIRED)
Phone number of trainer (REQUIRED)
How will you exercise your dog?
What will you do with your dog when you travel?

Pet Experience

Have you owned a dog in your adult life?
If yes, what happened to him/her?
Have you ever had a pet die at an early age?
If yes, please explain?
Do you have pets now?
If yes, list current pets here
Name Type/Breed Age M/F Neutered (yes/no) Behavior with other dogs
What dog food do you plan to feed (brand, dry/moist)?
What behavior would cause you to give up your dog?

REFERENCES

Veterinarian name
Phone
Address
City
State
Zip code
Is this the vet you:
Two other references
(Relatives are not acceptable)
REQUIRED
Name Phone number Relationship
How did you hear about MLRR?
Have you read the MLRR adoption policies?
Do you agree to abide by the policies?
Additional Comments?
I certify that the information I provided in this application is true and correct. I authorize MLRR to contact any and all references to verify the information that I have provided. I am at least 18 years of age. This dog will reside in my home as a pet. I will provide it with adequate food, water, shelter, training, affection, and medical care. I understand that it is my responsibility to see and evaluate the dog for myself before agreeing to adopt it. I will not relinquish ownership, abandon, or dispose of such a dog in any way. If I cannot keep it, I will relinquish the dog over to MLRR. I am in full agreement with these terms of adoption. I acknowledge that any misrepresentation will disqualify me from approval. I also acknowledge that misrepresentation may result in removal of the adopted Lab from me by MLRR.

Midwest Labrador Retriever Rescue, Inc. reserves the right to refuse or deny any application.