Application

Please complete all the fields on the form below to apply.

 

Warrior Application

*Required
*Name:
*Address:

Address 2:
*City:

*State:
*Zip:

*Email:
*Phone:

*Employer:
*Employer Phone:

*Position:
*Working hours per day:

*What Branch of the Military did you serve?:
*Where did you serve?:

*What is your start date of service? :
*What is your end date of service? :

HOME INFORMATION:

*House or Apartment?:


Landlord's Name (If Apartment):

Landlord's Phone (If Apartment):
Fenced Yard? (If House):



What kind of fence and how high?:
*Number of people in the household:

*Ages of people in the home:
*Children in household (provided ages):

*Activity level in the home:

DOG INFORMATION

*Where will the dog sleep?:
*Woofs For Warriors provides free training for you and the dog, would you be willing and able to get to classes?:



*Do you have transportation?:


*How many hours a day will the dog be left alone in the house during the day?:

*Where will the dog be left alone?:
Other (be specific):

*Will you use a dog crate if necessary?:
*How will you exercise the dog daily?:

*What is your plan to discipline the dog if needed?:
*Do you have any other pets in the house?:

If other animals, are they spayed or neutered?:
*Are you willing/able to keep the dog current on vaccinations, heart worm medications and flea and tick sprays or meds?:

*Current Veterinarian:
Veterinarian Phone:

Veterinarian Address:
*Have you ever had a dog before?:

*Under what conditions would you no longer wish to keep a dog?:
*What happened to your last dog?:

*Is there any specific qualities you would like your dog to have?:
*What types of breeds (and mixes) to you prefer?:

*What size dog to you prefer?:



*Male or female preference:



*Up to what age of dog will you accept?:
*Do you require the assistance of an aid or family member for daily living skills? If so, what are that personís responsibilities and number of hours worked?:

*Have you ever been convicted of a misdemeanor, summary offense, or felony related to the abuse, mistreatment, neglect or harm to a person or animals?:


If yes, describe in detail including the state and date in which the conviction was made:

REFERENCES

No family members.

*1) Name:
*1) Address:

*1) City:
*1) State:

*1) Zip:
*1) Phone:

*2) Name:
*2) Address:

*2) City:
*2) State:

*2) Zip:
*2) Phone:

*3) Name:
*3) Address:

*3) City:
*3) State:

*3) Zip:
*3) Phone:

All references will be checked.

*Signature:
*Date:

Your signature above constitutes consent to release veterinarian treatment information to the Mountains to Miracles Woofs for Warriors Program and permission to contact all references provided for the purposes of dog adoption and any follow up care. Making sure you are matched to the right dog, and maintaining the health of your dog is key to starting off a great relationship between you and your new dog. Therefore, we request that your information with Woofs For Warriors remain current for purposes of follow up between you and your dog.

All liability with your dog will be ultimately the responsibility of the signee. The Mountains To Miracles Veterans Foundation/Woofs For Warriors retains superior title of all adopted dogs. If a veteran wishes to surrender the dog, it must go back to Woofs For Warriors/Mountain to Miracles Veteran Foundation.