Name:
Address:
Phone Number:
Your E-mail:
Are you adopting this dog for yourself or for someone else(such as for a gift - please explain):
Any other residents? (Yes or No)
Spouse/roommate(name):
Do you have children? (Yes or No)
Are you or anyone else in household retired? (Yes or No)
If so who?
Enter age place an X in the appropriate box
18-30
31-45
45-60
60+
Employment
Employer's name(applicant):
Position(occupation):
Address:
Phone Number:
Do you work full time or part time:
Hours per week:
Do you live in an apartment, condo, mobile home, or house?
Do you rent or own?
Do you have a fenced yard? (Yes or No)
If "yes" fence type:
If you rent does your landlord allow you to have pets? yes or no
May we contact your landlord? yes or no
Landlord Name:
Landlord Phone:
Any other pets currently? (Yes or No)
If yes, how many?
Dogs (List breeds, sex, ages):
Cats(declawed?):
Other:
Are there situation in which you would allow your rescue schnauzer off leash?(Yes or No)
What are they (in back yard, running in park, etc.)?
Where will your new dog spend most days?
Where will your new dog spend most nights?
How will your new dog get exercise?(examples: running in the fenced yar, walks on leash, dog park, etc.)
Do you have a regular veterinarian? (Yes or No)
May we contact your veterinarian? (Yes or No)
Name:
Clinic:
Address:
Phone Number:
Personal references
(groomer, pet-sitter, co-worker, friend, neighbor, etc. No relatives, please):
Name:
Relationship:
Address:
Phone Number:
Name:
Relationship:
Address:
Phone Number:
Briefly explain why you would like a miniature schnauzer:
Questions/Comments:
Information about the dog you would like to adopt, as appropriate:
Gender preference: (Enter Male, Female or Either)
Age range: (enter range or doesn't matter)
Color Preference:
(Salt & Pepper, Black, Black & Silver, or Any)
Ears: (Cropped, Natural, or Either)
Breed: (Purebred, Mix, Either)
Are you interested in adopting a specific dog from MSRSofNE? (Yes or No)
If yes, please give the dog's name and your reason:
Special requirements (household, good with kids/dogs/cats, non-shedding, etc.)?
Would you consider adopting a special needs pet? Example of special needs:
Minor: arthritis; bladder stones (special diet from the vet required);
medication-controlled minor illness.
Major: blind; diabetic requiring insulin injections; epileptic;
unsocialized/poor temperment?
Yes or No:
Are you financiallly prepared to provide care and upkeep for a dog at this time
(about $600/year)?
Yes or No:
Mini Schnauzer Rescue Service of New England is not for profit;
all donations go towards the care of our dogs. We do not get large numbers
of schnauzers into our rescue program, and we usually have a waiting list for
adoption. Most of our rescues are middle-aged (6-9 years old)
and are housetrained.
All dogs are spayed/neutered prior to placement, and we bring them up to
date on shots, groom them, and take care of basic medical needs such as
heartworm screening, dental cleaning, and cyst removal.
Adoption fees are donations to Schnauzer Rescue, not payment for value received,
and are primarily based on the age and health of a particular dog, and our expenses.
Donations for senior and special needs dogs are generally $50-$100,
while adoption fees for our other rescues normally range from $100-$400.
Completion of MSRSofNE Adoption Application does not guarantee approval.All dogs subject to prior adoption
I ascertain that I have answered all of the above questions truthfully and to the best
of my knowledge, the above information is correct, and I give my permission
to contact the references I have provided.
Enter Name:
Date:
Press "Submit" to Send your application directly.
10-1-01 - UPDATE - Until further notice, PLEASE PRINT out this form and mail it to: MSRSofNE - APPLICATION - 89 School Street, Walpole, MA 02081
- Mini Schnauzer Rescue Service of New England
Walpole, MA
Questions? Please call MSRSofNE: (508) 668-2197