Michigan Standard Poodle Rescue & Re-Homes Share

Adoption Application

Thank you for your interest in adopting a Standard Poodle through Michigan Standard Poodle Rescue. Please complete all fields as thoroughly as possible. All fields are required unless otherwise noted.

About You

Full Name *

Age

Spouse / Partner Name

Spouse / Partner Age

Home Address *

City *

State

Zip Code *

Email Address *

Cell Phone

Home Phone

Work Phone

Your Place of Employment

Spouse Place of Employment

Do either of your jobs require travel?

Yes No

About Your Home

Type of Residence

House Condo/Townhouse Trailer Home Dormitory Apartment Other

If Other, please specify residence type

How long have you lived at this address?

Does your landlord / association allow dogs?

Yes No N/A

Name of Landlord / Condo Association

Landlord / Association Phone

Plans to move in the next few years?

Yes No

Times moved in the past 5 years

What would you do if you moved to a residence where dogs are not permitted?

Describe your yard

No yard Unfenced yard Partially fenced yard Completely fenced yard

Do you agree to keep your dog on a leash at all times when outside the fenced area?

Yes No N/A

About Your Family

Adults in household

Children in household

Ages of children

Number of children who visit

Ages of children who visit

Are all household members in agreement about adopting a dog?

Yes No

If no, who and why?

Is anyone nervous or unsure around dogs?

Yes No

For whom would you be adopting this dog?

Primary caregiver for the animal

Financially responsible for the animal

Willing to have all household members meet the animal?

Yes No

Does anyone have asthma or allergies to dogs?

Yes No

If yes, who has asthma or allergies?

How many hours would the dog be alone during the day?

About Your Current Pet(s)

Current pets — one row per pet:

Name	Species / Breed	Spayed/Neutered	Age	Gender	Owned How Long?	Vaccines?

If you have a dog, does it get along with other dogs?

YesNoN/A

Current veterinary hospital

Experiencing any difficulties with current pets?

Yes No

Please describe any difficulties

Pet History

Have all family members been around dogs?

YesNo

Have you been primary caregiver to a dog before?

YesNo

Have you ever given a pet away, to a shelter, or sold it?

YesNo

Have you had a pet short-term that did not work out?

YesNo

Have you ever retrieved a pet from a pound or shelter?

YesNo

Have you had a dog that gave birth?

YesNo

Pets owned over the past 10 years — one row per pet:

Name	Species / Breed	Spayed/Neutered	Owned How Long?	What Happened To Pet?

Plans for Your New Pet

Where specifically when all have left?

Longest time the dog will be left alone?

Where will the dog sleep?

How often and where will you exercise the dog?

Planned veterinary practice

Planned vet phone

If not yet spayed/neutered, do you intend to?

Intend to have it spayed/neuteredIntend to let it have puppiesNot Sure

Aware some dogs require weeks/months to adjust?

YesNo

Willing to allow for the adjustment period?

YesNo

Willing to bring dog to yearly vet exams?

YesNo

Able/willing to pay for emergency vet care ($200â€"$1,000+)?

YesNo

Able/willing to pay for all pet expenses?

YesNo

Able to commit to providing a home for the life of the dog?

YesNo

Circumstances that might justify giving up a dog (check all that apply):

Baby Moving Shedding Want to travel None Other

Seek MSPR advice if dog has behavioral issues?

YesNo

Willing to pay for obedience/behavioral sessions?

YesNo

Who cares for your pets when you travel overnight?

What food and treats do you feed your dog?

Preferences

Reasons for adopting (check all that apply):

Companionship Watch dog Other

When relating to dogs, I consider myself:

Strict - a strong leaderLenient - easily coerced by the dogSomewhere in between

My ideal dog would:

Bad doggie habits I cannot tolerate:

Anything you would like us to know about the new dog you want:

Experience with dogs rescued from puppy mills?

Yes No

Please explain your experience with puppy mill dogs:

Experience with Standard Poodles?

Yes No

Please explain your experience with Standard Poodles:

Willing to have an in-home visit by a MSPR representative before and after adoption?

YesNo

Personal References

#	Name	Relation	Phone
1
2
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Additional Information

Please provide any additional information relating to adopting a poodle: