| Date |
|
| First Name |
 |
| Last Name |
|
| Street |
|
| City |
|
| State |
|
| Zip |
|
| Phone (home) |
|
| Phone (work) |
|
| Phone (cell) |
|
| Email |
|
| Do
you currently own pets? |
|
| List, (Name, breed, sex, age) |
|
| All
dogs and cats Spayed? |
|
| If
not spayed why not? |
|
| Are
the pets current on Rabies |
|
| All
pets heartworm tested |
|
| Monthly Heartworm
preventative |
|
| Have you had any Past Pets? |
|
| List all Past Pets & what happend to them? |
|
| Vet
Name |
|
| Vet
Address |
|
| Vet
Phone Number |
|
| Vet
records are in the name of |
|
| Do
your Rent or Own your home? |
|
| Home Type |
|
| Landlord Name |
|
| Landlord Phone No. |
|
| Is
there a Pet Deposit? |
|
| Is
there a Weight limit? |
|
| Pet
Deposit Amount |
|
| Pet
Rent |
|
| Do
you understand that Min Pins tend to bark a lot and might not
make good apartment pets if other tenants are not tolerant of
barking |
|
| Is
your yard completely fenced in? |
|
| Type of fence |
|
| Fence Height |
|
| How
do you plan on exercising your Min Pin? |
|
| Do
you have a crate to keep the dog in? |
|
| How
many hours will the dog be alone during the day? |
|
| Where will you keep the dog while you are at work or
out on errands? |
|
| Where will you keep the dog while you are on
vacation? |
|
| Why
are you interested in adopting a Miniature Pinscher? |
|
| Do
you have a preference of Male or Female? |
|
| Please describe any preferences you might have about
the age of a min pin you would be interested in
adopting.Preferences |
|
| Is
there a particular Min Pin you are applying to adopt? |
|
| If
yes, what is the Name, State and Tag number of the dog you are
interested in? |
|
| How
many adults are presently living in the house? |
|
| Men
in the home |
|
| Women in the home |
|
| Do
you have roommates? |
|
| Have they agreed to have this pet in their home? |
|
| If
you and your pet will live with a roommate or your parents for
any part of the year, please provide their information. |
|
| Do
your roommates have pets? |
|
| If
yes, please list Name, Age and Type of Pet. |
|
| Are
there children presently living in the house? (name and
ages) |
Ages & Name: |
| We do not adopt to homes with children
under 10 except in cases where specific dogs have successfully
lived with children in the past. |
| Do
you understand that AMPS requires a home visit prior to
adoption and in some cases after adoption? |
|
| I
am prepared to take on the responsibility of caring for this
dog for its lifetime, an average of 12 - 18 years |
|
| I
am willing to spend the time, patience and money to properly
train a dog? |
|
| I
understand that a Miniature Pinscher should never be allowed
off lead in open spaces? |
|
| How
far are you willing to travel for a minpin? |
|
| Please list a personal reference: (Required
information is Name: address, phone number
and relation to you) |
|
|
Adoption
Donations Are As
Follows:
- Healthy dogs up to 2 years
of age: $300.00 -
$350.00
- Healthy dogs
between the ages of two and six: $150.00 - $300.00
- Healthy dogs
between the ages of six and nine: $75.00 - $150.00
- Geriatric or “special needs” dogs: donation is
set on a case -by -case
basis.
The
Donation Fees Above Do Not Reflect Any Vet Fees Which Will
Need To Be Reimbursed To AMPS. Donations
Made Are Necessary To Continue Needed Medical Care For The
Minpins AMPS Assists. For
Your Convenience AMPS Can Accept Money Orders, Cashiers Or
Bank Checks And Paypal.
Incomplete applications will not be
processed |
| By
checking “Yes” here, I certify I agree to the information in
the above paragraph pertaining to the adoption donations. |
|
| By
checking “Yes” here, I certify that the above information is
true: |
|
| Any
additional comments you would like to share? |
|
|
- Required field
All Miniature Pinscher Service, Inc. reserves the right to reject any application at any stage without assigning any reason. |
|
|