0
7506,7505,7503,7512,7513,7519,7518,7508,7502,7492,7490,7496,7500,7480,7431,7486,6944,7311,7471,7474,7476,7477,7475,7469,7467,7335,7452,7459,7460,7353,7392,7428,7420,6086,7429,7192,7037,7410,7411,7384,7393,7396,7399,7390,7356,7265,7336,7210,7266,7253,7228,7186,7160,6924,6825
Nola 6512
Nola 6512
Nola 6512
Trombone Joe 6511
Trombone Joe 6511
Trombone Joe 6511
Prairie 6509
Prairie 6509
Prairie 6509
Alfalfa 6508
Alfalfa 6508
Alfalfa 6508
Duffy 6516
Duffy 6516
Duffy 6516
Neon 6521
Neon 6521
Neon 6521
Trucker 6519
Trucker 6519
Trucker 6519
Surprise 6515
Surprise 6515
Surprise 6515
Fetching more mutts ...

Adoption Questionnaire

Are you 62 or older? You can participate in our Seniors for Seniors Adoption Program by filling out our Seniors for Seniors Adoption Questionnaire instead.

Please answer the following questions so that we can make a great match for you and your new animal companion. There are no wrong answers! Contact us if you have problems or questions in filling out this questionnaire.

GENERAL INFORMATION

Telephone:

     

Are you a veteran?    

Are you 62 years or older?    

WHAT BROUGHT YOU TO MUTTVILLE

How did you hear about Muttville? Check all that apply.

 

 

 

What relationship does this person have to Muttville? Check all that apply.
       

Which one(s)?
   

What kind?
     

 

YOUR NEW DOG

Have you ever had a dog before?    

Do you prefer a:      

What size dog do you prefer:        

Is any member of your household allergic to dogs?    

LIVING SITUATION

For each adult occupant of your home, including you, please supply their name, their age, and their relationship to you:

You

3rd adult occupant


3rd adult occupant


4th adult occupant


Do you:    

If you rent, do you have written permission from your landlord to have a dog?    

Do you have stairs inside or leading into your home?    

Do you have a pool?               Is it fenced?    

Will you allow us to visit your home?    

CURRENT ANIMALS IN YOUR HOME

Do you currently have other pets?    

ADDITIONAL COMMENTS

CERTIFICATION