CMAR Adoption Application

Chasing Miracles Animal Rescue - Adoption Application
All adopted animals can never be given away, sold, bartered, or surrendered to any one. If at anytime you cannot keep your adopted animal it must be returned to CMAR and you will not receive a refund for your adoption fee.

All cats must be indoor cats and never declawed! All dogs cannot be kept on a chain or tie out, and their appearance can never be altered for aesthetic reasons! No ear cropping, tail docking, or dew claw removal unless deemed necessary by a licensed veterinarian for health reasons!
Name of the animal you want to adopt*
Adopter's Legal Name*
First & Last Name
Co-Adopter's Legal Name
First & Last Name
Physical Address*

Street Address

Street Address Line 2

CityState

Zip Code
Adopter's E-mail*
Co-Adopter's E-mail*
Phone Number*

Area CodePhone Number
Phone Type*

CellHomeWork
Adopters Birthdate:*
Adopter's Drivers License Number & State*
Are there children who will live in the home with the adopted animal?*

YesNo
If yes please list all children's ages. If no type n/a.*
Current pets in your home*
Are all of the pets in your home spayed or neutered?*

YesNo
If no please explain:*
Are all of the pets in your home current on vaccinations, heartworm, and flea or tick prevention?*

YesNoNA
Vet reference (please call your vet and give permission to release information to us)*
Vet name, address & phone number
Where do your current dogs live?*

Inside our homeIn kennelsIn our yardThey free range on our property.Other
Where will your adopted dog spend most of his/her time?*

In my home with me.Outside in my fenced in yard.Outside allowed to free range.In boarding/daycare/with a dog sitterOther
Have you given away or rehomed an animal within the last year?*

YesNo
If yes to the above question please explain.
Have you or anyone in your household ever been convicted of an animal related crime?*

YesNoOther
Are you planning to move in the near future?*

YesNo
If moving soon, to what city/state?
When will you be ready to adopt?*

TodayThis weekendWithin a weekWithin a monthNot ready yet, just researching
Are you in contact with any other rescues or shelters about a specific animal?*

Yes, application is pendingYes, just an email inquiry, no app yetNo, but I am looking at several others onlineNo, I am only interested in this particular animal
Are you going to meet another animal?*

YesNo
If so, when?
Does anyone in your home have an animal allergy?*

YesNo
Is anyone in your home afraid of animals?*

YesNo
Does anyone in your home smoke?*

YesNo
Are you familiar with animal regulations in your area? EX: Animal limit laws, BSL, etc.*

YesNo
I/We live in a*

Single Family HomeDuplex/TwinCondo/TownhomeTrailerApartment
Do you rent or own this property?*

RentOwn
If you rent please list landlords name, address, and phone number: (YOUR APPLICATION WILL AUTOMATICALLY BE DENIED IF WE CANNOT CONTACT YOUR LANDLORD AND VERIFY PET STATUS)
Do you have a yard?*

Yard, fenced (please list type below)Yard, fenced with invisible fencingYard, no fenceNo yard (apartment/condo/townhome)
If fenced list fencing type, height, and how many gates there are:
Do you work outside the home?*

YesNoOne applicant is home/works from home
If you both work outside the home, how many hours per day are you away?
How many hours per day will the animal be alone? Explain*
Have you discussed this adoption with all members of your household?*

YesNoYes, adults have discussed. Kids don't know yet.
Based on the descritption in the animal's bio, do you feel pretty confident that you will be likely to adopt this animal upon meeting it?*

YesNoNot sure
- We will be speaking to all household residents to confirm everyone is aware of this application process and wants to have an animal added to the family. Please do not submit this application if you are "trying to talk someone into" adopting this animal or think "once they meet him/her, they will want one" or "I'm getting this animal as a present for them." In those scenarios, you are welcome to email us to discuss the situation, but we would like all adults in the home to be involved in that discussion. The actual adopter must be the one to fill out the application.
Upon meeting the animal, what would give you cause to not want to adopt it? Please explain.*
What activity level do you prefer?

Wild and crazy is coolLeash trained daily jogging partner would be excellentMedium energy, plays a bit then hangs out with youLow energy, walks slowly on leash, a total couch potatoOther
Please check all that apply. I want to adopt this animal...*

As a family petTo breed with my dog/catTo train/use for huntingTo train/use for agilityTo train/use as a therapy dog/catTo train/use as an assistance dog for the disabledTo use as a guard dogFor a jogging/hiking partnerTo interact with lots of friends/familyAs a gift for a friendAs a companion for my dog/cat(s)As a companion for my children/grandchildren
Please check all that apply. My adopted animal will...*

Be kept outside most of the timeBe kept indoors most of the timeBe left outside during the work day while we are awayBe kept inside while we are awayBe crated when we are not homeHave free reign of the house when we are not homeBe taken to formal obedience classesBe trained by me/usTake frequent car rides with usBe kept on a lead line/cable in the yardBe mostly interacting with adultsBe interacting frequently with children under 8Be interacting frequently with older childrenMust be housebroken prior to adoptionWill be housetrained by usWe be walked more than one mile per day every dayWill be walked occasionallyBe attending formal group obedience classes with usBe trained by us without the advice of a trainerHave private sessions with a trainer as neededBe attending agility classesBe taking frequent car rides/trips with usBe boarded when we go on vacationStay with family when we go on vacationBe given away to someone else if we feel it's not a good match for usBe turned in to a shelter if we can't keep itBe going camping with usBe going on boat trips with usOther
Please take time to think, be honest with yourself and us when answering this question. What are you absolutely NOT willing to deal with at the time of adoption or at any time during the life of the animal?*

HousebreakingChewingJumpingPulling on leash during walksCounter surfingObedience trainingFear of menFear of womenFear of childrenMouthiness (may sometimes snag your hand or arm instead of the toy in play and will need redirection/training)GrowlingBarkingRough play with my dogHigh activity levelFood/toy aggression/not willing to share with other dogsFood/toy aggression with peopleWhining/cryingCounter surfingBlindnessLimited SightDeafnessSeparation AnxietyDiabetesSpecial DietLong Term MedicationIncontinence / Leaking UrineGets stressed/carsick when riding in vehicleDoesn't know how to climb stairsCan't climb stairs due to age/arthritis/health issuesHeart conditionSkin allergiesFood allergiesTrimming nailsYeast on coat or in earsEar mitesFleasTicksHeartworm preventativeAnnual heartworm/lyme combo testingOther
What would cause you to return an animal?*
How long do you feel is a reasonable adjustment period?*
How do you plan to integrate this animal into your family?*
What would you do if you discovered after adoption (at any time during the life of the animal) if your vet diagnosed an expensive health condition?*
How long have you been looking for an animal?*
Do you plan to take formal obedience classes?*

YesNo
Please list 2 personal references (name, address, phone number):*
Do you have any additional comments, questions or concerns? Anything else you would like us to know to help match you up to an animal?*
Please read the above, check this box, sign, and click Submit.

I/We have read and understand all of the above. I understand that CMAR has the right to refuse adoption to anyone they feel unfit. CMAR has the right to regain custody of my adopted animal at anytime if they feel that the animals welfare is in danger. I give CMAR the right to come to my home and perform a home visit, as well as to talk to my friends, family, and/or landlord about myself and my home.
Applicant's Signature*
Co-Applicant's Signature
Signature date*
Should be Empty:

Chasing Miracles Animal Rescue - Adoption Application

All adopted animals can never be given away, sold, bartered, or surrendered to any one. If at anytime you cannot keep your adopted animal it must be returned to CMAR and you will not receive a refund for your adoption fee.