Adoption Form

In order to be considered for an Adoption, you must observe the following:

You must be at least 19 years of age
You must be willing and able to care and have stability for the dog
You agree to contact Marley’s Hope if you need to re-home your adopted dog
You are willing to show proof of ID during the home visit

APPLICANT INFORMATION

The Dog's Name *:

Full Name *:

Home Phone Number *:

Cell Phone Number:

Work Phone Number:

Email Address *:

Name of Spouse/Partner (if applicable)

Street Address *:

City *:

Postal Code *:

Applicant's Employer:

*IF YOU ARE A RENTER, WRITTEN PERMISSION FROM YOUR LANDLORD IS REQUIRED*

Do you own or rent your residence? *

Landlord Information (if applicable)

Personal References

Please provide two personal references that we may contact

Reference One:

Name *:

Relationship to Applicant *:
FriendEmployerFamilyOther

Phone Number *:

Reference Two:

Name *:

Relationship to Applicant *:
FriendEmployerFamilyOther

Phone Number *:

VETERINARY REFERENCES

PLEASE CALL YOUR VET CLINIC TO LET THEM KNOW WE WILL BE CALLING
TO DO A REFERENCE CHECK ON YOU AND YOUR PETS
Please assure the vet(s) will have the following information:
Proof of spay/neuter
Proof of vaccinations

Veterinarian:

Vet Clinic Name *:

Phone Number:

Other Veterinarian (if applicable):

Vet Clinic Name:

Phone Number:

Questions

Please answer the following questions as completely as possible.

1. Where will the dog be kept during the day, night, and while you are at work? *

2. How many hours on a typical day will the dog be left alone? *

3. Do you have/access to a yard? *
NoYes

4. Is your yard fenced in? *
NoYes And if so what kind of fence?

5. How often, and what type of exercise do you plan on doing with your dog? *

6. Why do you want to adopt a dog and this dog in particular? *

7. What do you think are the most important responsibilities in owning an animal? *

8. Are you willing to take the time to work with a pet on housebreaking issues, should the need arise? *

9. Do you understand and accept that changing an animal’s environment may cause the animal to have accidents, especially in the early days of the adoption? *

10.If a behavioural problem arises, what steps will you take to work on it? *

11. For past or present dogs, what kind of training methods did you use to train them? *

12. Does any member of the family have any allergies to animals? *
NoYes If yes, please describe

13. Do you currently have any pets? *

If yes, please describe (List current pets, type (ie dogs, cats), names, age, spay/neutered?, how long you have had each pet?) *

If not, have you ever owned a pet before? Describe pets you have had in the past 10 years and why you no longer have them *

14. What kind of veterinary care do you intend to provide, and how much do you expect to spend on veterinary care, toys, food and training over the course of a year? *

15. How many people currently reside in your household? *

16. Are there children in your household? *
NoYes If yes, what are their ages?

17. Do they have experience handling animals? *
NoYes If yes, please describe?

18. In the absence of the primary caretaker, who will take care of the dog? *

19. Are you aware and do you accept that Marley’s Hope Rescue requires that all existing animals in the household be spayed/neutered before adoption of a rescue animal can take place? *

20. If you are unable to keep your dog, do you agree to return him/her to Marley’s Hope Rescue without hesitation? *

21. Have you ever been convicted of or investigated as in relation to animal abuse; neglect or fined under either the Provincial Dog Act or Municipal Animal Control By-Laws? *

22. Do you understand that this dog is the property of Marley’s Hope Rescue and you may not adopt it to anyone, give it away, sell it, adopt it out to anyone else, abuse or breed it. You are not permitted to allow anyone else to take this dog without the knowledge AND consent of Marley’s Hope Rescue. *

23. Do you accept that Marley’s Hope Rescue makes no explicit or implicit guarantees in reference to the health, and/or temperament of the dog and that Marley’s Hope Rescue in no way can be held liable with regards to this adoption placement. *

24. Marley's Hope is a proud partner with 24PetWatch. By clicking below, if I am chosen to adopt this animal, I consent to 24Petwatch to reach out to me by phone, mail or email. These communications will be about the following:
• Information about your pet’s microchip – essential to ensuring your pet can get home safe in the event they ever get lost
• 24PetWatch Insurance options that can help protect your pet and your wallet.
• Special deals and discounts on products and services and partner product and services.
24Petwatch protects your privacy and ensures your personal information is kept current, confidential and secure. They are committed to strict guidelines of confidentiality and security to responsibly safeguard your information. By clicking yes below, I understand the disclosures above about the reasons Pethealth Services Inc. and PTZ Insurance Services Ltd may call, mail or email me in the future. I understand that they may use automatic telephone dialing systems or pre-recorded/automated messages. These calls and their contents can be reviewed during the adoption process if I so wish. I consent to receive these calls at the number I provided and acknowledge that I can decline to receive them in the future if I choose. I also acknowledge that my consent to receive these calls is not a condition of the purchase of any goods or services. If you click no then there is no way for 24PetWatch to contact you if your pet is lost. There will be an option to remove yourself from mailing lists and sales calls once you register your chip post adoption. *