Adoption Application

We serve Eastern PA, and parts of NJ, MD and DE. All dogs are shown by appointment only to approved applicants. At this time, all dogs are in private foster homes and we do not have shelter facilities that can be visited.

Please Note: Our adoption process includes home visits, therefore, our adoption area is limited to 100 miles of Philadelphia, Pa. If you are outside of our adoption area, please visit siberianrescue.com or petfinder.com to locate rescues in your area. Don’t forget to check with your local shelters ~ many Siberians end up there!

If you are interested in a specific Siberian Husky or Husky mix currently featured on our site, please indicate which one(s):

Please indicate the time frame you had in mind for adopting a Siberian Husky or Husky mix:

Today's Date:

Applicant Contact Information

Applicant Name (required)

Street Address (required)

Address 2

City (required)

State (required)

ZIP

Occupation (required)

Employer (required)

Home Phone (required)

Cell Phone

Work Phone

Email (required)

What is the best way to contact you?

When is the best time to contact you?

Are you over 18?

Please note: Applicant must be over 18 years of age

Co-Applicant Contact Information

Co-Applicant Name

Occupation

Employer

Home Phone

Cell Phone

Work Phone

Email

What is the best way to contact you?

When is the best time to contact you?

Are you over 18?

How did you hear about MaPaw?

If a Friend/Family Member referred you, please tell us their name:

If we met you at a Meet & Greet, please tell us where:

If other, please explain:

Have you adopted from MaPaw before?

If yes, please tell us the dog's name and when you adopted him/her:

Why have you chosen to adopt a Siberian Husky?

Have you or your co-applicant ever applied to another rescue to adopt an animal?

If so, please list the names of all rescues that you or your co-applicant have applied to in the past:

Are you currently working with a rescue, in addition to MaPaw, to adopt a dog?

If so, please list the names of all rescues that you are currently working with:

Personal References

Please list no more than 1 family member.

Reference 1

Name (required):

Relationship to Applicant (required):

Address (required):

City (required):

State (required):

Phone (required):

When is the best time to contact them?

Reference 2

Name (required):

Relationship to Applicant (required):

Address (required):

City (required):

State (required):

Phone (required):

When is the best time to contact them?

Reference 3

Name (required):

Relationship to Applicant (required):

Address (required):

City (required):

State (required):

Phone (required):

When is the best time to contact them?

Please tell your references that they should be expecting a call from the volunteer processing your application.

Animal Ownership and Experience

Have you ever owned a Siberian Husky or Husky mix?

If yes, please tell us about him/her:

Do you currently have any pets?

If yes, please tell us about them:

Current Pet #1

Type of Animal:

Name:

Breed:

Age:

Sex:

Neutered or Spayed?

Current on vaccines (if applicable)?

On Flea/Tick Preventative?

If yes, what type?

On Heartworm Preventative?

If yes, what type?

Current Pet #2

Type of Animal:

Name:

Breed:

Age:

Sex:

Neutered or Spayed?

Current on vaccines (if applicable)?

On Flea/Tick Preventative?

If yes, what type?

On Heartworm Preventative?

If yes, what type?

Current Pet #3

Type of Animal:

Name:

Breed:

Age:

Sex:

Neutered or Spayed?

Current on vaccines (if applicable)?

On Flea/Tick Preventative?

If yes, what type?

On Heartworm Preventative?

If yes, what type?

Current Pet #4

Type of Animal:

Name:

Breed:

Age:

Sex:

Neutered or Spayed?

Current on vaccines (if applicable)?

On Flea/Tick Preventative?

If yes, what type?

On Heartworm Preventative?

If yes, what type?

Current Pet #5

Type of Animal:

Name:

Breed:

Age:

Sex:

Neutered or Spayed?

Current on vaccines (if applicable)?

On Flea/Tick Preventative?

If yes, what type?

On Heartworm Preventative?

If yes, what type?

If you own any cats, are they declawed?

Please list any other animals currently in your home including breed, age, sex, neuter/spay status and vaccine status (if applicable):

Please tell us about any pets that have lived with you, not already listed above, within the last 10 years. If they are no longer with you, please tell us the circumstances.

Have you ever sold, given away or surrendered a pet to a shelter or rescue group?

If yes, please explain the circumstances.

Are you familiar with the use of a dog crate to train and/or confine the dog while he or she is unsupervised?

If your adopted dog requires it, are you willing to crate train and use a crate?

Why do you want to adopt a MaPaw dog? (check all that apply)
 Companion Watch Dog Gift Playmate for Current Dog For Kids Obedience Exercise Companion Outdoor Activities (hiking, mushing) Other

If other, please describe:

How many hours on average will your adopted dog spend alone?

Where will your adopted dog spend the day? (check all that apply)
 Loose Indoors Crate Basement Garage Loose Outdoors Tied Up Outside Kennel Run Other

If other, please describe:

Where will your adopted dog spend the night? (check all that apply)
 Loose Indoors Crate Basement Garage Loose Outdoors Tied Up Outside Kennel Run In Bed with Owner Other

If other, please describe:

Siberian Husky Breed Information and Preferences

Are you aware that Siberian Huskies and Husky mixes are very active dogs and will require daily exercise?

Are you aware that Siberian Huskies and Husky mixes shed A LOT and year round?

Do all members of your household want to adopt a Siberian Husky or Husky mix?

Do you prefer a male or female Siberian Husky or Husky mix?

Please identify the age range you are primarily interested in adopting:

If there are children in the household, have they been taught how to appropriately interact with an animal?

Given the Siberian personality for escaping and roaming, will you teach all household members the importance of never taking the dog out without a lead and the importance of making sure all gates and doors are secure?

Are you aware that routine costs of maintaining a dog average $800 to $1200 per year?

If your adopted dog develops a serious illness, injury or health condition at some point in his/her life, are you prepared to obtain the necessary/appropriate medical care?

Veterinarian Referral Request

Do you have a regular veterinarian?

Veterinarian's Name:

Veterinary Hospital Name:

Phone Number:

Please alert your Veterinarian's Office that MaPaw will be contacting them for referral purposes and give approval to release necessary information to MaPaw.

Home Environment

Do you own or rent your home?

If renting, do you have the landlord's permission to keep a dog larger than 50 pounds?

If renting, please list the landlord's contact information:

Name:

Organization (if applicable):

Phone Number:

Best time to call?

Please specify type of dwelling:

If other, please describe:

How long have you lived at this address?

Do you have a fenced in yard?

If yes, please tell us about the type of fencing (check all that apply).
 Under 4 foot 4 foot 5 foot 6 foot or higher Wood Panel Chain Link Split Rail with Wire Split Rail Only Kennel Run Picket Invisible Privacy Other

If other, please explain:

If you do not have a fence, how do you plan to exercise the dog and manage toilet duties?

How many adults currently reside in your household?

Please list the names and ages of all Adults currently living in the household:

How many children currently reside in your household?

Please list the names and ages of all Children currently living in the household:

Are there regular visitors to your home (human or animal), with which your new dog must get along?

If yes, please describe:

The Legals

Are you able and willing to comply with MaPaw's requirements that an adopted dog must NEVER be off leash except in securely fenced areas?

Do you agree to allow a representative of MaPaw to visit your home by appointment?

If not, please tell us why:

 I/we understand and accept the ADOPTION FEES are $275, unless otherwise stated. (required)

 I/we understand that completing this application does not guarantee that a dog will be placed with me. (required)

Enter this text in the field below: captcha

By clicking the "Submit" button, you attest that all of the information you have provided in this application is true and correct.