Adoption Application

Thank you for your interest in adopting a dog. Please fill out the required fields below and we will get back to you as soon as possible.

Applications will be considered if the following criteria is met:

1. All information is filled out including first and last name and address.

2. Must have a valid email address. We mainly correspond through email.

3. Have a fully fenced in yard if you live in a home- we do perform home checks prior to adoption.

Name of Dog(s) or Cat(s) Interested in

Are You Interested in A Male or Female Dog/Cat?

Male

Female

No Preference

Breed of Dog/Cat You’re Interested In?

Is Size a Determining Factor? If So, What Size Are You Looking For (Small, Medium, Large, XL)

Activity level on a weekly basis?

Low

Medium

High

Do You Have Any Questions Regarding This Animal?

Applicant First Name

Applicant Last Name

Occupation

Name of Spouse/Significant Other.

What Is Your Spouses Occupation?

Ages of Children, if Any

Email

Phone

Do you live in a house, apartment, condominium, townhouse, or other? If "other" please specify.

House

Apartment

Condo/Townhouse

Other

Address

Address Line 2

City

State

Zip / Postal Code

How Long Have You Lived at Our Current Residence?

Do You Rent or Own?

Rent

Own

What Type of Fence Do You Have on Your Property?

We Do Not Adopt out Unless There Is a Secure Fence

We Do Not Adopt Dogs to Live Outside. Is This Something that You Are Ok with & Understand?

Are There Other Pets in The Home?

Yes

No

What Pets Have You Had in The Past? Please List All.

What Happened to The Ones You No Longer Have?

What Would Happen to The Dog if You Moved?

Where Will the Dog/cat Go when You Go on Vacation?

How Long Will the Dog Be Left Alone During the Day? and Where Will the Dog Be when You Are Gone? (crate Trained, in House, Etc)

Do You Have a Regular Veterinarian?

Yes

No

Does Anyone in Your Household Have Allergies? if They Do Please Specify What Kind.

Have You Ever Adopted from Us Before? if So Please Explain:

Have You Ever Surrendered a Dog/ Cat Before? if So Please Explain:

How Often Do You Plan to Exercise Your Dog?

If You Need to Relocate, how Will Your Dog/cat Fit Into that Plan?

Do You Foresee Any Major Life Changes Over the Next Two Years? (e.G., Promotion/transfer at Work, Military Deployment, Relationship Change Such as Marriage, Remodeling Your Home or Yard, Having Children)

Adopted Dogs Experience an Adjustment Period of At Least Several Months. You Are Fully Committed to Adjusting Your Life to Help Your New Dog Learn to Feel Safe?

Have You Ever Had a Dog with Behavior Problems? if So What Behavior(s) and How Did You Work with Your Dog on This Issue?

Do You Understand that We Do Not Adopt Dogs/cats to Be Kept Outdoors Full Time?

Will You Be Committed to Potty Training?

Yes

No

Will You Be Able to Live with Hair on Your Furniture, Stains on Your Rugs, a Warm Body on Your Bed, and An Animal that Might Be Destructive at Times?

Yes

No

Remember, Pets Are an Investment of Your Time and Money. Can You Afford to Provide Medical Care, Grooming, Proper Diet, Proper Shelter and Exercise for Your New Pet?

Yes

No

If Your Dog Were Injured or Ill, Are You Committed to Take Him/her to The Vet?

Yes

No

Are You Able to Make a Long Term Commitment to Care for This Dog for Its Entire Lifespan, Which Could Be as Much as 10-20 Years?

Yes

No

Under What Circumstances Would You Not Be Able to Keep This Dog/cat ?

MANDATORY STATE SPAY/NEUTER LAWS ENFORCED UNDER AUTHORITY OF LOCAL SHELTERS! ALL PETS MUST BE SPAYED/NEUTERED WITHIN 30 DAYS OF ADOPTION UNLESS THEY ARE TOO YOUNG, IN WHICH CASE A DEADLINE DATE WILL BE SET AND SECOND CHANCE MANSFIELD WILL REMIND YOU OF THAT DEADLINE. FAILURE TO COMPLY WILL RESULT IN RETURN OF THE PET TO SECOND CHANCE MANSFIELD

I Understand that Second Chance Mansfield Reserves the Right to Refuse Adoption to Any Client for Any Reason. by Checking the Box Below I Affirm and Certify that All the Information and Answers to Questions Herein Are Complete, True, and Correct.

adoption Application form

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