First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

Country

Email*

Home Phone

Work Phone
x

Cell Phone*

Alt Email

Text/Pager Email

Gender*
Choose one: Male Female

What is your date of birth?*

Today's Date *

Which animal are you interested in?
Choose an animal: Adolfo Allegra Anita Bettina Connie Ettore Gianna Gracie Livia Smokey

Before you complete this form Mastino Rescue Inc would like to share the following adoption statement. At this time we are unable to adopt to: -- Homes with children under the age of 10 (Bite liability and insurance restriction) -- Families that are renting their residence (Moving and unable to keep or Landlord restrictions are in the top 5 reasons for surrendering a dog) -- Homes with intact adult dogs (without a veterinary waiver) -- Homes with same gender mastiffs or bully breeds as the desired dog (Same sex aggression is extremely common for Neapolitan mastiffs) -- Homes that rely upon underground electric fence for containment (Such fences do not keep people and other animals OUT. The stoic Neapolitan does not respect such fences) Please acknowledge you have read these restrictions.
Choose all that apply: Yes No

Are there children under the age of 10 in the home?

How many people reside in the household? List the names, ages, and genders of all household members:*

Have you ever owned a large breed dog? If so, when?:

Have you ever fostered or owned a Neapolitan Mastiff before?
Choose one: Yes No

If so, when did you own a Neapolitan Mastiff?

List all animals residing in the home, who are owned by you or anyone else residing there. List the animals species, name, breed, gender, age and spay/neuter status. If none, please answer, none:*

Do any of your pets have strong LIKES (i.e. smaller dogs or dogs their own size)?*

Do any of your pets have strong DISLIKES (i.e. a male dislikes male dogs)?*

Are all of your pets up to date on all vaccines, INCLUDING Rabies?*
Choose one: Yes No

If one of your pets is not up to date on vaccinations, please explain why:

Where will the dog be kept during the day?*
Choose one: outside yard inside inside crated outdoor kennel/run doggy daycare

Where will your dog be kept at night?*
Choose one: outside yard inside inside crated outdoor kennel/run doggy daycare

How many hours a day will the dog be home alone?*

Where will the dog stay when you are not home?*
Choose one: outside yard inside inside crated outdoor kennel/run doggy daycare

Is your yard fenced?*
Choose one: No Yard Unfenced Yard Yard Partially Fenced Yard Completely Fenced

What type of fence?*
Choose one: Privacy Chain Link n/a

What is the height of the fence? (Write "n/a" if you live in an unfenced residence.)*

Please describe your home:*

How long have you lived at your current address?*
Choose one: 0-2 2-5 5 +

If you have lived at your current residence less than 2 years, please provide your previous address:

Do you own or rent your home?*
Choose one: Rent Own

If you rent your home, please provide name, address, and telephone number for your landlord:

In the event the primary caretaker experiences a health emergency, who would assume the caretaker role?

Provide your veterinarian contact so we can verify the vaccination and spay/neuter information for all listed pets in the home. If you do not have a current veterinarian, provide previously used vet:*

How would you plan to pay for an expensive veterinary event (example - cost of over $1000)?

Do you understand that Mastino Rescue spays/neuters all dogs PRIOR to adoption (With exceptions to age and health)?

Personal reference. List name, address, telephone number, and email:*

Personal reference 2. Include name, address, telephone number, and email:*

Personal reference 3. Include name, address, telephone number, and email:*

List behaviors you are comfortable working with:*

List behaviors you are uncomfortable working with:*

How did you learn about Mastino Rescue Inc.?*
Choose one: Facebook Internet Search Referred by friend Referred other rescue Returning adopter

Are you willing to abide by your state’s laws regarding animal care and containment?*
Choose one: Yes No

Why are you interested in adopting a Neapolitan Mastiff at this time?*

If, for any reason, you cannot keep your Neapolitan Mastiff, do you agree to return him or her to Mastino Rescue Inc.? *
Choose one: Yes No

Please list any additional information that will help us evaluate your application to foster/adopt a Neapolitan Mastiff from Mastino Rescue Inc.:

I acknowledge that I am aware that Mastino Rescue Inc. may do a criminal background check by clicking below I permit a criminal background check to be done. *
Choose one: yes

I agree to sign and scan all needed documents back to the rescue. (If you are unable to scan the documents, you can download the ScanNow app on your phone and submit all needed documentation that way.)

I CERTIFY THAT ALL INFORMATION ON THIS FORM HEREIN AND ALL ATTACHMENTS ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND BELIEF. BY SIGNING BELOW, I CERTIFY THAT ALL INFORMATION IN THIS FORM IS COMPLETE AND ACCURATE TO THE BEST OF YOUR KNOWLEDGE. PLEASE TYPE YOUR NAME, FOLLOWED BY TODAY'S DATE:*