Name:
Home address:
Home phone number:
Cellular phone number:
Daytime phone number:
Best time and place to reach you:
Email address (Please watch your bulk mail folder for email responses from us.):
Type of pet you want to care for:
Size of pet best suited to your home and family:
Does everyone in your household support having senior pets live with you?
Do any children or grandchildren live in your home or visit regularly?
Are you planning a baby in your future?
Do you or anyone in your home suffer from allergies?
Who will be the pet’s primary caregiver?
If you move, how will you handle the pets?
Do you own or rent your home?
What type of home is it?
If you have a yard, is it fenced?
What type of fencing and how high?
If renting, name and address of landlord (verification is required that you are authorized to keep pets in your apartment).
What activity level would your lifestyle provide the pet?
Rescued pets typically have suffered varying degrees of neglect and/or abuse and, as a result of such life trauma, may exhibit behavioral improprieties. Are you prepared for and experienced in dealing with behavioral issues such as chewing, barking, marking, scratching, running away, food aggression, hiding?
What is your general approach to handling behavioral issues?
How did you hear about Milagro Senior Pet Refuge Inc?
Have you ever been turned down for volunteering or fostering by any other rescue organization?
Where will the senior be primarily kept?
How long during the day will the pet be crated or home alone?
Most of the seniors that come to Milagro suffer physically, whether through injury, neglect, abuse, or simply age-related infirmities. Acknowledging that there are typically unknown medical issues that come with these seniors, are you still willing to take a 'special needs' senior, to provide the intensive level of care, patience, and attention required to make the remainder of its life comfortable with as much quality as possible, and to remain lovingly devoted to the senior as it reaches its life's end? are you able to also provide financially for this care as needed?
Do you have, or have you had in the past 5 years, any other pets?
Please describe (type, age, why you no longer have them):
If you have any questions relative to the application process, or relative to being a Milagro guardian, please list them here.
Please provide names and phone numbers of two character references not related to you.
Please provide name, address, and phone number of your veterinarian.
By submitting this application form online, I do hereby certify that the information provided herein is true and complete to the best of my knowledge. I also understand and acknowledge that any intentional misrepresentations on my part during this application process likely will prevent approval of my application. Milagro Senior Pet Refuge Inc. is authorized to contact my character references and my veterinarian (and landlord, if applicable) as designated in the answers above.
