Application

Golden Years AMR adoption application

Personal information

Name

Address 1

Address 2

City

State

Zip code

Your home

Do you rent or own?

Is there any restriction on owning pets?

Is your yard fenced?

If yes, what type of fence do you have?

How high is the fence?

How many people are in your household?

Any children under 18?

What are their ages?

References

Name

Address

City and State

Phone

Name

Address

City and State

Phone

Name

Address

City and State

Phone

Please provide the name, address and phone number of three references including your landlord if applicable. References could include friends, neighbors, employer, relative, etc. Please include the area code with phone numbers.

May we call your vet for a reference?

Vet / Clinic name

Vet's address

City and State

Phone number

Other information

How many hours a day will the dog be alone?

Where will the dog sleep?

Where will the dog spend the day?

Who will have the primary responsibility for the dog's care?

Did you know every dog is spayed/neutered before adoption?

Did you know that the dog must be on heartworm prevention?

Describe your experience with Alaskan Malamutes

What do you like least about Alaskan Malamutes?

Why do you wish to adopt an Alaskan Malamute?

Which sex do you prefer?

What would you do if the dog got lost?

Where is the nearest animal shelter?

What will you do if the dog marks in the house?

Type of pet

Will you buy and use a crate?

If you answered no, please explain

History of pet ownership

Spay/Neutered?

Sex of pet

Name of pet

How long owned?

Type of pet

Spay/Neutered?

Name of pet

Sex of pet

How long owned?

Type of pet

Spay/Neutered?

Name of pet

Sex of pet

How long owned?

Are these pets housed inside or out? Please explain.

What animals currently live in your household?

What animals have you had in the past? Please list the type of animal, pet's name, how long owned and what happened to them.

Pet type

Name of pet

How long owned

What happened to pet

Pet type

Name of pet

How long owned

What happened to pet

Pet type

Name of pet

How long owned

What happened to pet

Pet type

Name of pet

How long owned

What happened to pet

Pet type

Name of pet

How long owned

What happened to pet

Which Malamute(s) are you interested in and why?

How would you like us to contact you?

Additional comments or information

All of the information I have provided above is true and complete to the best of my knowledge. Should a dog be placed with me, it will reside in my home as a family member. I agree to provide the dog with adequate food, water, shelter, affection and medical care.

Please be sure to fill out each section completely.

Missing information could delay the processing of your application.

Upon successful transmission of the application, you will be redirected to our home page.

E-signature (name of applicant)

Date of application

Home phone

Work phone

Cell phone

E-mail