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Adoption Form

    I would like to AdoptFoster

    Are you 25 years of age or older? YesNo

    Your Info:

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    Address:

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    Contact Info:

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    Residence:

    Do you own or rent? OwnRent

    If you rent, please include contact information for your landlord:

    Do you anticipate relocation? YesNo

    If so where to?

    Do you have a 2nd residence? YesNo

    Address of 2nd home:

    Dog Info:

    Are you interested in a particular NMDR dog or breed? If so, which one:

    What kind of dog are you looking for?


    Please describe your yard and fence situation (be specific: height, material, gates):

    Please list the dogs you have most recently lost - maximum of 3 dogs.

    Why do you no longer have these pets?

    List all other family pets you have now including: age, best guess of breed, sex, and if they are spayed or neutered, and where they are kept (inside or outside)

    List human family members and ages

    What amount of time will dog(s) be left alone everyday and where will they be kept while you are away?

    How would you describe your lifestyle?

    How will you exercise your dog?

    How would you react if your dog destroyed a household object or soiled in the house?

    Where will your dog stay when you are out of town?

    Dog Preferences:

    Do you prefer: MaleFemaleNo Preference

    Would you consider a dog with the following needs?

    Do you prefer: YoungYoung AdultAdultSeniorNo preference

    I would like my dog to be:

    How energetic should your dog be: Very livelyLivelyQuietNo preference

    How much grooming do you expect to do: A lotModerateA littleNone


    Why have you chosen to adopt a mill dog?

    Is there anything else we should know to help us match up your family with the right dog?


    How did you hear about National Mill Dog Rescue?


    I plan on adopting: ImmediatelyIn the next monthIn the next three monthsIn the next six months

    Thank you so much for your interest in our organization and our dogs!

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