Adoption Application

Name

Address

City

State

Zip

Home Phone

Work Phone

Cell Phone

Rent or own?

If rent, name, address and phone number of landlord.

Previously owned dog?

List family members, including childrens' ages

Please describe your yard and details of fence (ie material, gates, height, etc)

List family dogs including breed, age, sex, spay/neuter

Where will your dog sleep?

May we contact your vet as a reference?

Vet Contact Informaton

Please note that Mill dogs often need extra patience and care, especially in the areas of housetraining and socialization, due to being caged all their lives and generally neglected. Mill dogs as with all other dogs want to be clean and want to be a part of the family but they often require extra patience during their training.

How would you react if your dog destroyed a household object or soiled in the house?

Are you interested in a particular MDRN dog? Which one:

Breed Desired

Gender

Age Desired

Grooming Required

Energy Level

Is there anything else we should know to help us match up your family with the right dog?

Would you consider a dog with special needs such as, blindness, deafness, very fearful, very few or no teeth, health problems or old age? Please elaborate with this answer if yes!

How did you hear about Mill Dog Rescue Network?

How will you exercise your dog?

What amount of time will dog(s) be left alone everyday and where will they be kept while you are away? (Some mill dogs have separation anxiety once they’ve found the love of a human!)