MCSPCA

Montgomery County SPCA
Society for the Prevention of Cruelty to Animals
Serving Maryland, Virginia, and Washington, DC since 1973

Dog Foster/Adoption Application

Please take your time and carefully fill out this form, providing explanations wherever necessary, so that we can match you with the dog that best fits your lifestyle. When you are finished, please click the Send button on the bottom of the form to send your application.

On most browsers, you should use the TAB key to move between fields.

1.	Applicant Information
a.	Name
b.	Age
c.	Address:
	City, State, Zip
	Phone Number
d.	Employer
	Position
	Phone
e.	Email Address
f.	Are you interested in:	Adopting a dog Fostering a dog
g.	If you're interested in a particular dog, please enter it's name:
h.	What is your ideal time frame for adopting or fostering?	Right now Next week Next month No real time frame

2.	Co-Applicant's Information
a.	Name
b.	Age
c.	Relationship to Applicant	Spouse Parent or Guardian Child Roommate Other
d.	Employer
	Position
	Phone
e.	Email Address

3.	Indicate your preferences for a dog
a.	Sex	Male Female Either Sex
b.	Energy Level	High Energy Medium Energy Couch Potato
c.	Hair Length	Long Hair Short Hair
d.	Weight	Under 15 pounds 15 - 35 pounds 35-50 pounds 60 - 80 pounds Over 80 pounds
e.	Any particular color?
f.	Is shedding a concern?	Yes No
g.	Is noise a concern?	Yes No

4.	Questionnaire
a.	Why do you want to adopt/foster a dog?
b.	Do you live in:	House Townhouse Apartment Duplex Condominium
c.	Do you rent or own?	Rent Own
	If rental, name & phone of landlord
d.	Do you have a fenced yard?	Yes No
	Type of fence
	Height
e.	Where will this pet be kept during the day?
	Where will this pet be kept during the night?
f.	How many adults live in your household?
	Children?
	Ages of children
g.	Is anyone home during the day?	Yes No
	If yes, who?
h.	Does anyone in your household have allergies?	Yes No
i	Who will be responsible for caring for this animal?
j.	How many hours will this pet be alone during the day?
k.	Will this dog be tied outdoors during part of the day?	Yes No
l.	We require that all dogs adopted be spayed or neutered. Do you have any questions or reservations about this?	Yes No
m.	Under what circumstances would you have to give up the dog? (Check all that apply).	Moving New baby Divorce Dog becomes ill Dog behavior Other
	If you checked behavior or other, please explain.
n.	Who will care for this animal when you go on vacation?
o.	Are you willing to spend time training the dog to deal with problems such as jumping up, barking pulling on the leash?	Yes No
	Would you be interested in taking an obedience class with the dog?	Yes No
p.	Have you ever had a pet die at an early age or due to an accident?	Yes No
	If yes, please give details
q.	How will you exercise the dog and where?
	Time available for exercising dog
r.	Name and phone number of your vet
s.	Please describe in as much detail as possible the daily routine you plan for your dog.
	Morning
	Afternoon
	Evening
t.	How did you hear about the MCSPCA?

5.	Please list the pets you have owned in the past
	Type	Sex	Age	Spayed/ Neutered		Where is it now?
a.				Yes	No
b.				Yes	No
c.				Yes	No
d.				Yes	No
e.				Yes	No

6.	Give the names and phone numbers of two references
a.
b.

7.	If you are interested in volunteering with the MCSPCA, please indicate your interests:
	Foster Home	Special adoption and fundraising events
	Handling Phone Inquiries	Interviewing adopters
	Other:

8.	If the MCSPCA does not currently have a dog for adoption that matches your specifications, may we hold your application OR share it with other area animal shelters?
	Yes No

If you have any questions about the application or our organization, call the MCSPCA at 301-948-4266 and leave a message for "DOG COORDINATOR" in the ADOPTION voice mail box. The process takes approximately 7-14 days, and we are all volunteers, so please be patient.

If you would like to mail this form to the MCSPCA instead of submitting it online, please mail your completed application to :

MCSPCA
Attn: Dog Adoption Coordinator
PO Box 1181
Washington Grove, MD 20880

When you are finished filling out this form, please click the Send button below.

If you have any questions, please email us and we'll answer you as soon as possible! You can call the MCSPCA at 301-948-4266. For info on how to write to us, see our contact page.

Copyright � 1995-2007, Montgomery County SPCA