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  •  Adopted Sam 15 from MAESSR.  Most wonderful dog ever! Debbie,  VA
  • MAESSR is the best.  Debbie, VA       
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Adoption Application

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Your Price: $5.50


* denotes required field

Your full name*
The full names of all adult members of the household*
Your email address (e.g.:*
Your home phone number
Your cell phone number
Address (if PO or RR or RD box, please include appropriate street address*
How did you hear about our rescue?
Number and Ages of children living in the household or visiting regularly
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If you plan on having children in the future, what would you do with your rescued springer?
What type of area do you live in?*
Do you own or rent?*
House or apartment?*
If you rent, do you have written permission from your landlord to keep a dog?
Will you provide a copy of that permission to MAESSR?
Is there a weight limit for dogs in residence at your rental property? If so, how much?
If you own a condominium, will you provide a copy of your condo's pet policy?
Name of your veterinarian
Phone number for your veterinarian
Fax number for your veterinarian
May we contact your veterinarian?
What other pets live in your home(please include age, sex, whether spayed/neutered & if cat, declawed)?
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Have you ever been convicted of animal cruelty, abuse, and/or abandonment pursuant to any past and/or present laws of the state(s) or municipality(ies) where you have lived in the past or currently?*
Have you ever owned a dog before?*
Have you ever owned an English Springer Spaniel before?
What do you know about English Springer Spaniels?*
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What sex/age/color Springer are you interested in?
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Would you consider opening your heart and home to a senior Springer, 8 years or older?
Would you consider a "special needs" Springer?
Do you have a fenced yard?
If you don't have a fenced yard, how will your rescue Springer be exercised?
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What kind of activities do you plan on participating in with your rescue Springer?
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Have you ever taken a dog to an obedience class?
Will you be taking your rescue springer to an obedience class?
Where will your rescue springer be during the day?
Where will your rescue Springer be at night?
Are you familiar with the use of a crate?
Will you be crating your rescue Springer?*
If you move, what will you do with your rescue Springer?*
Do you agree to a personal interview with one of our volunteers?*
Do you agree to a home visit by one of our volunteers?*
MAESSR requires that all adults living in the home be present during their telephone interview, please remember this when setting up your interview date and time with our volunteer.
Are you prepared to pay an adoption fee.*
Any Other Comments:
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You will be contacted by one of our volunteers who will ask for the name of your most recent veterinarian or two personal references who are familiar with your interactions with animals if you haven't had a veterinarian at all or recently. Please have the information ready when contacted by your interviewer, it will make the review process quicker.

Adoption fees, effective April 18, 2014: Puppies 6 months or less will be $400; dogs 7 months to 3 years old will be $325; dogs 4 to 8 years old will be $275; and dogs 9 years or older will be $150.  This fee defrays, but does not cover the costs of alteration, veterinary care and immunizations.

Adoption fees can now be paid via credit card or Paypal by making arrangements a head of time once you are offered a dog during the adoption process.

Please take the time to read our FAQ page before your interview.

Thanks for applying!

Your application has been forwarded to our Applications Coordinator. A volunteer will be in touch with you shortly to schedule an interview

If you have any problems accessing the on-line application or have other questions concerning your application, contact the Application Coordinator.