Phone Numbers: Home: Cell: Work

Adoption Profile

Date: Name: Street Address: City: State: Zip: Email Address: Phone Numbers: Home: Cell: Work: 1. Do you belong to any online community forums? 2. If so, what are your screen names? 3. Are you on Facebook? A. We have a Facebook group that we’d like you to join. This is a place where MRR adopters can give updates, post questions and hear about MRR events. To join, search for MRR Adoption Counselor and request to join the group. B. What is your name on FB? 4. Are you over the age of 18? 5. Do you own or rent your home? 6. Landlord’s name and phone number: 7. Please list 2 personal adult references: names, phone numbers, email addresses and relationship (Only 1 may be a housemate, if you include spouse or family members we would like two additional adult references.) 8. Which animal are you interested in? 9. Why do you want to adopt this pet? 10. Please tell us your experience with this type of pet: 11. Please tell us about the pets you have at home: 12. Please tell us about your previous pets and where they are now: 13. Have you ever rehomed a pet? If so, please explain the circumstances. 14. Please tell us how you plan to house this pet, cage, bedding, food, etc. (Be very specific please.) a. Where in the house will the pet’s cage be kept? b. Cage make & model or 3 side dimensions and wire spacing size: c. Bedding choice(s): d. Toys/Hammocks/Chews: e. Food of choice: f. Type of Travel Carrier 15. Tell us about the people who live in your home. (Full names of all adults and ages on everyone please) 16. Are all members aware and in agreement of this adoption? 17. Do you have a veterinarian experienced with this type of pet? a. If not, would you like us to help you find one? b. May we contact your veterinarian for a reference? c. Veterinarian’s Name and phone number (for all of your pets): 18. Have you ever adopted from, volunteered for and/or been employed by a rescue group? a. If so, who were they and may we contact them for a reference? 19. Have you ever adopted this kind of animal from a breeder? a. If so, which one and may we contact them for a reference? 20. Have you ever bred this type of animal before? If so, please explain the circumstances: 21. Are you considering breeding this animal? 22. Are you able to travel to meet or pick up this pet from its foster home? If so, how far? (Please be specific on how far you can travel one way.) 23. Do you have any questions regarding this specific animal? 24. Do you have any questions that we can answer to help this become a successful adoption?

By sending in this adoption profile you agree that the information you have given us is true to the best of your knowledge. No signature is required at this time. You may use as much space as you need. Knowingly providing false information will result in the denial of your application.

****************************************************************************************** ADMINISTRATIVE USE ONLY: ADOPTION COUNSELOR: BACKGROUND CHECKS:

CAGE: (Type, height, width, depth, wire spacing, # of rats) BEDDING: FOOD: TOYS/HAMMOCKS: CARRIER: VET: TRAVEL INFO:

OTHER NOTES:

APPROVED/DENIED: