MADACC Adopter Profile MADACC Adopter Profile First Name * Last Name * Interested in a: * Dog Cat Previous MADACC Applicant? * Yes No Street Address * Apt. or Unit# * City * Zip Code * Primary Phone * Cell Phone * Email * Driver's License Number * Are you over 18? * Yes No Do you own or rent? What is your housing situation? * Own Rent Live with parents Other If you checked "Other" please explain * I am permitted to have a pet (dog or cat) at my residence? * Yes No MADACC relies on applicants to be aware of any restrictions on animals being permitted at their residence, owned or rented, including number of animals permitted, size, species and breed restrictions. MADACC expects that you have permission from your landlord and have paid any required deposits and made any and all other necessary arrangements prior to bringing your new pet home. * I understand and will be fully responsible for consequences for bringing animal home where not permitted. Names and ages of all residents in the home: * Existing Pets in the home: * Dog(s) Cats(s) Small Animal(s) Please list animals and ages, breed, species * Are your current pets spayed/neutered? * Yes No Your existing pets live * Indoor Outdoor Indoor/Outdoor How would you describe the activity level in your home? * Zen Garden (calm) Average (normal family activity) Circus-like (non-stop) How much time do you spend away from home on average? * Home all day or most of time 4 - 7 hours 8 - 12 hours My pet will be around children? * Yes No What experience do you have with pets? * First time Childhood pets Experienced I would consider an animal with special needs * Yes No Maybe - depending on the condition and care necessary What are you looking for in a new pet? * Couch Potato Running/Hiking partner Good with children Dog Friendly Cat Friendly Always by my side Very Outgoing Laid Back Cuddle buddy Guardian Social Butterfly Best Friend Working Animal Able to be alone More Independent Playful What topics would you like information on? * Proper Feeding Pet Proofing Crate Training Litterbox Training Grooming Training Introducing New Pet Future Vet Care Exercise/Toys Declawing (why not recommended) Other If you checked "Other" please explain: * Milwaukee Area Domestic Animal Control Commission (MADACC) reserves the right to refuse an adoption to any applicant for any reason. I certify that the information I have provided is true and understand that giving false information may result in the denial of adoption. I understand that this is a profile and not an application and filling out this profile does not constitute an approved adoption application. In consideration of MADACC allowing my/my family’s interaction with animals, I agree to release and hold harmless MADACC from and against any loss, damage, injuries, claims, liabilities and expenses of any nature whatsoever, including without limitation attorney’s fees and disbursements. I understand if an accident or injury should occur, no matter how minor, that I will notify a MADACC staff member and seek medical attention utilizing my own medical insurance. I understand that there are risks inherent in handling animals and accept those risks. By checking YES below I confirm that I have read and understood this waiver and accept all risks. * YES If you are human, leave this field blank. Please print this form (print the page do not go back or you will lose the data) and bring it in with you or you will need to fill out another one when you arrive at MADACC
