Click here for information on adoption fees and our application process! All required fields must be filled in for the form to submit successfully. Go backThank you for your submission! Please note that it may take up to two weeks for you to be contacted. Adopter Information Name: First and Last(required) Warning Birthdate (YYYY-MM-DD) Warning Physical address Warning Phone number(required) Warning E-mail Warning Have you ever surrendered a pet to a shelter?(required) Select one option Yes No Warning If you have surrendered an animal, please describe why. Warning Have you ever been convicted of neglect or cruelty to animals?(required) Select one option Yes No Warning Are you willing to have a Little Mittens Animal Rescue Association representative do a home visit by appointment?(required) Select one option Yes No Warning If you are not willing to schedule a home visit, why not? Warning Home and Family How many adults are in your home? Select one option 1 2 3 4 5+ Warning How many children are in your home? Select one option 0 1 2 3 4 5+ Warning Ages of children (if any). Warning Does anyone in the home have allergies to dogs? Select one option Yes No Warning How busy is your family? Select one option Very Moderate A little Not at all Warning How would you describe the environment in your home? Select one option Quiet/Calm Moderately noisy Loud/Frantic Warning Type of home? Select all that apply.(required) House Apartment Acreage Shared Owned Rented Warning If you rent, do you have the landlords permission to keep a pet? Select one option Yes No Warning Outside areas? Select all that apply. Balcony Patio Yard None Warning Are you planning on any of the following in the next 6 months? Select all that apply.(required) Moving Holiday New baby New job None of the above Warning Current Pets How many animals are in your home?(required) Select one option 0 1 2 3 4 5+ Warning List all current pets. Include their name, breed, sex, age, and if they are spayed/neutered.(required) Warning How are your pets with other animals?(required) Warning Have you had a dog before?(required) Select one option Yes No Warning Do you have a family vet? (required) Select one option Yes No Warning If yes, who is it? Warning Where will your dog stay during the day?(required) Select one option Inside Outside Both Warning Where will your dog sleep at night?(required) Select one option Inside Outside Both Warning How often will you walk your dog for exercise?(required) Select one option Very often Often Moderate Sometimes Never Warning Desired Characteristics Desired sex Select one option Male Female Either Warning Desired age Select one option Senior Adult Puppy Any Warning Desired coat length Select one option Short Medium Long Any Warning Preference for colour/breed/type: Warning What problems are you willing to work with/on? Select all that apply.(required) Digging Chewing Barking Housetraining Separation anxiety Fearfulness Shyness Nervousness Mild aggression I'm not willing to work on any problems Warning If you are not willing to work on problems, please explain why. Warning Under what circumstances would you return your dog? Select all that apply.(required) Aggression Chewing furniture House training issues Not getting along with other pets Too costly Not enough time Dogs health problems New baby Moving I would not return my dog under any circumstances Warning I would like my new dog to… .. be friendly with children.(required) Select one option Not important Somewhat important Very important Warning .. be friendly with other dogs.(required) Select one option Not important Somewhat important Very important Warning .. be friendly with cats.(required) Select one option Not important Somewhat important Very important Warning .. be friendly with me.(required) Select one option Not important Somewhat important Very important Warning .. be friendly with visitors to my house.(required) Select one option Not important Somewhat important Very important Warning .. to enjoyed being groomed.(required) Select one option Not important Somewhat important Very important Warning .. to enjoyed being petted.(required) Select one option Not important Somewhat important Very important Warning .. to be calm.(required) Select one option Not important Somewhat important Very important Warning .. to be active.(required) Select one option Not important Somewhat important Very important Warning .. to be playful.(required) Select one option Not important Somewhat important Very important Warning .. to be independent.(required) Select one option Not important Somewhat important Very important Warning .. to be quiet.(required) Select one option Not important Somewhat important Very important Warning .. to never wake me up at night.(required) Select one option Not important Somewhat important Very important Warning .. to never chew my furniture.(required) Select one option Not important Somewhat important Very important Warning .. to never show aggressive behaviour.(required) Select one option Not important Somewhat important Very important Warning .. to never have an accident in the house.(required) Select one option Not important Somewhat important Very important Warning Please include any additional information that can help us find the right match for your home: Warning References Please provide a non-family reference: Name, relation to you, phone number.(required) Warning Please provide a second non-family reference: Name, relation to you, phone number.(required) Warning Agreements and Consent Please check the boxes next to the statements below to indicate that you have read, understood, and agree to the following. If you are approved for adoption, this is considered the adoption agreement. It is my responsibility to see and evaluate the dog for myself before agreeing to adoption.(required) Warning To submit payment of the adoption fee to Little Mittens Animal Rescue Association upon pick up of the dog.(required) Warning This dog will reside in my home as a companion. I will provide him/her with adequate food, water, shelter, affection, socialization, and medical care.(required) Warning I will not sell, trade, give away, or otherwise dispose of this dog. If at any time I am unable or unwilling to care for this dog, I agree to contact Little Mittens Animal Rescue Association to return him/her or to discuss finding a new home. I understand that the adoption fee is non-refundable.(required) Warning Little Mittens Animal Rescue Association is in no way liable or responsible for any damage, accident, or injury resulting from the placement of this dog into my household.(required) Warning Little Mittens Animal Rescue Association cannot be held responsible for any health or temperament problems of this dog.(required) Warning Thank you for your interest in Adopting. Please allow up to two weeks for our team to review your application and contact you regarding your eligibility as an adopter. We reserve the right to refuse any applicant. Applicant digital signature (enter full name)(required) Warning Date (YYYY-MM-DD)(required) Warning Warning. SubMitSubmitting form Δ
