APLMC Adoption Application

ANIMAL PROTECTION LEAGUE

OF MERCER COUNTY

PO Box 663

Celina, OH 45822

Phone: (419) 586-2887

www.aplmercer.com

Email: info@apimercer.com
Name of Pet you want to adopt:*
Applicant's name*
Co-Applicant's name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Cell number:*
Co-Applicant's cell number:
Will this be an inside or outside dog?*
Are you looking for a long haired or short haired dog?*
What size of dog are you looking for?*
Does anyone in your home have an allergy to dogs?*
Are you looking for an active or quiet dog?*
Have you ever housetrained a dog before?*
If your dog behaved badly, how would you correct his behavior?*
Do you own your own home?*
If you're a renter, how long have you lived at this address? (Put NA if not applicable)*
If you rent, this has to be filled out or your application won't be processed.
If you rent, please provide Landlord's name and number: (Put NA if not applicable)*
If you rent, you must provide this information or your application will not be approved.
How will you exercise your pet?*
Do you have a fenced in yard? If yes, please describe area.*
How many hours per day will your pet be left alone for work?*
Where will you keep your pet when you're not home?*
How many adults live in the home? Please provide their ages?*
How many children live in the home? Please provide their ages?*
List any pets you currently own, including breed, sex, ages, and whether they are spayed or neutered:*
List any pets and why you no longer have them:*
What would cause you to no longer be able to keep this pet?*
What would you do if you couldn't keep this pet?*
What will you do with your pet when you're on vacation?*
Have you ever had a dog hit on the road before?*
Please provide your current vet clinic:*
Name of Vet clinic
Your Current Veterinarian's telephone number:*
Please call them and authorize us to get a vet reference or we won't be able to approve your application.
Please provide a personal reference:*
Personal reference's telephone number:*
Prefer a non-relative
Are you willing to allow a pre-adoption visit if needed?*
The Animal Protection League of Mercer County has set forth rules that we deem appropriate for the animal's needs. We do not wish to offend anyone nor are we trying to eliminate your application from being considered. We are trying to match the right dog with the right family so the animal has a forever home. As such, please carefully consider the following behaviors that you can not or will not tolerate in the pet. This will allow us to make the best match possible for both you and the animal.
Which behaviors would make you not want to adopt this dog? Please check all that apply.*

None of thesePet Chews belongingsPet barks too muchPet has housetraining issuesPet jumps on peoplePet is too hyperPet Sheds too muchPet requires too much groomingPet requires too much vet carePet digs holesPet pulls on leashPet doesn't interact well with family members & other petsOther
Have you ever applied to adopt a dog from other rescues? If yes, please provide name and number of rescue organization:
If so, what was the outcome:
I understand by adopting this pet, I agree to return it to the APLMC at my own expense if I'm no longer able to keep it for any reason. I agree to this condition:*
Please initial
I understand that the APLMC is not responsible or liable for this pet immediately upon receipt by me. I agree to this condition:*
Please initial
I understand that if abuse or neglect is found or if my check bounces, I am required to return the pet at my own expense upon written request: I agree to this condition:*
Please initial
I understand I will maintain this pet as a companion animal. This animal will NOT be used for fighting, baiting, or aggressive(attack or guard dog) training. I agree to this condition:*
Please initial
I understand if I violate some or all of this agreement, I will be called to court proceedings in Mercer County, Ohio, and I will be required to return the animal to the APLMC and pay court assessed damages for violating this contract. I agree to this condition:*
Please initial
I understand this is a legally binding contract upon my signature:*
Please initial
A non-refundable adoption fee is required for this pet:
Please fill in amount for adoption fee
Date of adoption:________________________________________

Applicant's Signature:________________________________________________

Co-Applicant's Signature:_____________________________________________

APLMC Representative Signature:_______________________________________
Should be Empty: