MPR ADOPTION & FOSTER APPLICATION

Completing this application does not commit you to an adoption or foster care. This form provides us with basic information to help determine if a dog or dogs you have interest in would be compatible to your family and lifestyle. This is only the beginning of our process to assure the best possible match and help you find a good companion that will meet your needs and requirements.

The more information you provide, the easier it will be for our reviewers to evaluate your application. All the questions in this questionnaire should be answered, and your email address must be correct in order for your application to be considered.

Before completing the form, please take a moment to review our adoption information at the link below.

ADOPTION INFORMATION & PROCEDURES

IMPORTANT! MPR IS AN ALL-VOLUNTEER GROUP. NO PAID STAFF. WE DO OUR BEST TO RESPOND TO EVERY APPLICATION WITHIN A WEEK. PLEASE CHECK ALL YOUR EMAIL FOLDERS. OUR REPLY MIGHT END UP IN A SPAM FOLDER.

Dogs Selection:

Name of dog(s) you are interested to adopt, foster or want to know more about: *

Second Choice

Third Choice

I have visited MPR's web site at mopitbullrescue.org , thoroughly read the bios and reviewed all information relevant to the dogs selected above: *

Yes

No

Not yet, but will do Not yet, but will do

Personal Information

Your name (first and last) *

Significant other's first and last name

Address *

City *

State *

Postal Code *

Do you live within city limit?

Yes

No

Unsure

If not in the Kansas City area, are you able to drive here to meet and possibly adopt one of our dogs?

Yes

No

Unsure

I would need help with transport I would need help with transport

How do you prefer that our first contact to you be made? *

Text

Phone Call

Email

Other: Other:

Primary Phone *

Type of Phone: *

Texts ok?

Yes

No

Email Address *

Do you read your email daily?

Yes

No

Your age group *

Applicants under 18 must provide the name & phone number of a parent or legal guardian:

Your occupation: *

Your significant other's occupation:

We like getting to know our potential adopters. Please be aware that if you dont have on-line presence, we may request a home visit prior to an adoption.

Social Media Used: *

Your Social Media URL or name used:

Your significant other's Social Media URL or name used

Have you ever applied for or adopted a dog from MPR before?

Yes

No

If so, please explain (Date, name of dog, etc) If so, please explain (Date, name of dog, etc)

Would you welcome a MPR volunteer in your house for a homecheck prior to adoption? *

Yes

No

Don't know

Living Situation:

How many adults (21 and older) TOTAL in your household?

How many individuals under 21 in your household?

What are the ages of individuals under 21?

Are children visiting your household on a regular basis?

LIABILITY AND RESPONSIBILITY

Have you ever been convicted of a felony? *

Yes

No

If yes, please explain (please include the year of the offense):

By checking YES you agree to absolve MPR and all of its representatives from any liability in reference to a dog featured in this program. *

YES

NO

ABOUT THE DOG(S)

Please select: *

I would like to give a dog a permanent home.

I'm interested in fostering only.

Open to foster with option to adopt.

Unsure - Have questions.

Interested in adopting two dogs.

Do you prefer:

A Male

A Female

Either one

If you have a preference in appearance such as color and weight, please describe it here:

Prefer the dog to be: *

Already spayed or neutered.

Unspayed or unneutered.

Doesn't matter (explain) Doesn't matter (explain)

Do you want a dog for:

Companionship.

Guard and protection.

Breeding.

Expectations:

I need a dog that MUST get along with other dogs.

I need a dog that MUST get along with other animals (ie cats).

I understand that MPR cannot guarantee the future behavior of a dog.

I understand the limitations and potential of Terrier and Bulldog breeds.

Additional requirements about the dog you would like to add:

HOME AND LIFESTYLE

Do you live in: *

Is your home located in:

An urban area

A suburban area

A rural area

Do you own or rent? *

I own home

I rent home

My parents own home

A Friend/Relative owns home

If you are renting, please provide name & phone # of homeowner or landlord (We will not process your application without contacting your landlord for approval):

If your parents, a relative, or friends owns the home, please provide their name & phone #

How long have you lived in current home?

If you move one day

I will make sure I move to a place that welcomes dogs.

I am aware that several cities and landlords have breed specific restrictions.

I will find my dog(s) a good home if needed.

I will relinquish my dog(s) to MPR.

I will relinquish my dog(s) to animal shelter.

Does your municipality have Breed Specific Legislation? *

Yes, and I meet restrictions - see below for specifics

No BSL - I called Animal Control and verified

Don't Know

BSL Restrictions

Dog's living situation: *

Dog will be house pet; living inside with family.

Dog will live in basement, garage, porch or sunroom.

Dog will live mostly outside; inside in bad weather.

Dog will live strictly outside with a doghouse.

Other (please explain) Other (please explain)

How many hours a day will dog be home alone? *

When home alone, dog will be: *

How will you exercise the dog? *

Leash walks every day.

Will have cable or dog run in the yard.

Will be free to run in fenced yard.

Will have supervised access to unfenced yard.

Will be free to roam around (Off leash and unsupervised in unfenced area).

Will bring to dog park (Public area where dogs can run and play together).

Home Yard size is:

Is yard enclosed by fence? *

Yes

No

Partially fenced

Will install or finish fence soon

Are there neighbors dogs in adjacent yards?

Yes

No

Occasionally

Unsure

If yard is fenced, please describe fencing (height and type).

Do you have doggy-door?

Yes

No

Plan to install one

OTHER PETS & EXPERIENCE

Do you have other DOGS? (Check all that applies) *

Please specify name(s), breed(s), age(s), and sex of other dogs *

Please describe other pet(s) living situation (inside, outside, crate, etc)

If you have or had other dogs in the past, please let us know their current disposition

Please specify what happened:

What other kind of animals do you own?

In your opinion, what are good reasons to get rid of a pet? *

Of all breeds available, why do you want a Pit Bull (or other breed offered by MPR)?

Experience: Please relate any prior experience you have had with this breed.

Veterinarian: Please supply the name and phone number of your current veterinarian, or the one who saw your previous pet(s), as well as the name of the pets. We suggest that you contact them to give them permission to speak with us so there is no delay in the application process. *

References: Please provide the name of your employer, as well as additional references that can attest to your character. *

Additional information you would like to provide about yourself and/or the dog you would like to adopt: