Contact Us, information on how to adopt and Adoption Form

info@muddypawsrescue.com
c/o Muddypaws Kennels 20429 North Rand Road Palatine Ilinois 60074 Phone: (847) 540 9451	For location Please see map at the bottom of the page

Contact form:
First name:
Last name:
Email address:
Mailing address:
Please state the nature of your enquiry
Best way to contact you:	Email address Mailing address

Adoption Application Form	Please fill out this application if you are interested in adopting our dogs. If you have trouble filling out the application form, press print and print off a blank form and we will be happy to assist. There are a few sections that are required completion but these have been kept to a minimum.
Name	* required
Address
Day Phone	* required
Evening Phone	* required
Employer
Email
Type of Residence	Please complete both sections choose Own Rent choose House Townhome Apartment
. Landlords Information Phone Number
Type of companion that you are seeking	puppy adult
Size of dog	small medium large
What energy levels are you looking for	High Medium Low
Name of dog you are interested in	* required
How many people in the household	1 2 3 4 more Adults 0 1 2 3 4 5 more Children
Please state age range of children	n/a 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 older Oldest or single n/a 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 older youngest
Why are you interested in adopting	check all that apply Companion for self Companion for family For Breeding Gift For Protection For a child replace a pet Companion for other pet other please complete reason below
How long have you considered adopting an animal
Is this your first pet	yes no
	If no, please list previous pets, duration you cared for the pet and reason and date departed
Name Duration Reason and date departed
Name Duration Reason and date departed
Name Duration Reason and date departed
Name Duration Reason and date departed
Name Duration Reason and date departed
Name Duration Reason and date departed
Name Duration Reason and date departed
Name Duration Reason and date departed
Do you currently have other pets	yes (please complete below) no
. Name Size/Breed Age How long owned
How do you plan to introduce the new pet to the household?
How do you handle a family allergy to pet?
How do you handle pet medical expenses? (Unexpected emergencies and diagnosed medical conditions)
How do you handle moving?
	Sometimes animals do not adjust to their new environment well. Are you prepared to spend several weeks, perhaps months, waiting for your new pet to adjust to a new environment? No Yes
	Please provide your Vetenarian Information for past and current pets: REQUIRED
Name of pet Clinic	* required
Address of clinic
Phone number	* required
Name's pet's file is under	* required
What vaccines does you current pet's or will you future pet receive and how often
Will your newly intended pet be an indoor or outdoor pet?	indoor outdoor
What is the longest duration you will leave your pet outdoors wile unattended?
Does your residence have any of the following (check all that apply)	yard Fence Dog Run Dog Door
Please specify type and height of fence
	Where will your pet be kept (free roam of house, crate, outdoors etc) At night Day time
	How many hours a day do you spend at home? Please indicate work schedules of all adults in the household   Work schedule
Name	Work Schedule
What brand/type of food do you plan to feed your pet?
If the animal you adopt is not spayed or neutered, do you plan to have him/her spayed or neutered?	yes no
Do you plan on having your pet enrolled in obedience training, if so where?
Who will be primary caregiver for the newly adopted animal?
Does anyone in the household have any known animal allergies, please specify:
How did you hear about Muddy Paws Dog Rescue?
Have you ever turned an animal into a shelter, if yes why?
	Animals are not perfect, and occasionally situations arise that were not planned for. Please explain in detail how you would handle each of the following situations. Applications will not be considered complete if these are not answered.   Consider that all of the following behaviors could occur while you are at home, but also when you are not.   Training is what would need to be done but please let us know what specific techniques you would use to train.
Jumping on furniture/counter tops/tables
Scratching/biting/ripping furniture
Chewing on plants/garbage/other
Barking
Play Biting
Urinates/deficates inside the house
Keeps you awake at night
Sheds excessively
Ruins an expensive article
	Please provide three references (not related to you) and their phone numbers:
Name	Phone number
	I certify that the information I have provided is accurate and honest
Name	* required
Date	* required

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Muddypaws Rescue