Mission Valley Animal Shelter

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DOG ADOPTION APPLICATION

MATCHMAKING FORM

Date

Dogs Name

First Name

Last Name

Physical Address

City/Town. (Required)

Phone

Why I wish to adopt:

Please describe your ideal dogs's personality and what you are looking for in a dog:

Please note: If we cannot get in touch with your references then we can NOT approve your application. So please let them know we will be calling and put someone who will be available to answer a few questions during our business hours 11:00am-5:00pm Tuesday-Saturday.

Please have references from two different households, who are also not related to each other.

NON-Family Reference 1

Phone

NON-Family Reference 2

Phone

Lifestyle (Working, Homemaker, Retired, Attending School)

Type of Housing (Home, Condo, Apartment, Mobile Home, RV, Live with parents?)

Fenced Yard? (Please include type and height)

Own or Rent?

Landlord's Name

Phone

Others in household (Include Ages)

My experience with dogs is: First Time, Had 1 or 2, Very experienced

Other pets in home: (Include sex, age, spay/neuter status)

Pets Owned Previously

Vet Clinic Name and the name on the account

Vets Phone Number

Have you previously adopted a pet from Mission Valley Animal Shelter?

Yes

Signature (Name)

Date

Thank you for submitting we will be in touch soon!

"A voice for those who cannot speak"

DOG ADOPTION APPLICATION

MATCHMAKING FORM

36251 N Reservoir Road
Polson, MT 59860

406-883-5312