| Your name: * |
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| Spouses name: |
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| Dog interested in (1st choice): |
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| Dog interested in (2nd choice): |
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| Email: * |
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| Address: |
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| City: |
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| Zip: |
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| Phone number w/area code: * |
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| Alternate number w/area code: |
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| Best time to call: |
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| Do you own or rent: |
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| Name of Vet (notify them we will be calling): |
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| Vet's phone number: |
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| Personal reference (must be included or application will be discarded): |
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| Phone number of personal reference: |
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| Other Animals (Name, Breed, Age, Sex (neutered/spayed) and current on vaccinations): |
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| Name(s) and age(s) of children either residing or visiting the home: |
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| Please list any other animals, other than those mentioned above, that you have owned in the past. Please list by type of animal, and what happened to them: |
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| Have you owned a dog in the past: |
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| Have you owned a puppy in the past:: |
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| Are you willing to use a crate for training purposes: |
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| If no, please explain why not: |
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| Do you have a fenced in yard: |
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| If yes, what type of fence?: |
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| Do you wish to adopt: |
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| Gender: |
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| Size preference: |
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| Is your family more active or laid back: |
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| Do you and your family go hiking, camping, fishing or participate in any other outdoor sports or exercise: |
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| Describe your household: (Is your household quiet, high-paced side with people coming and going, noisy?): |
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| Does your family have a sense of humor?: |
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| Have your children/visiting grandchildren been around dogs before? Are they respectful of animals?: |
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| Is anyone in your household bothered with pet allergies?: |
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| Will you allow the dog/puppy on furniture (many of our dogs are used to being on furniture)?: |
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| Will the dog/puppy be allowed to sleep with you on the bed once he is housebroken?: |
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| Will the dog be an inside dog, part of the family, or will be staying outside?: |
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| Are you willing to house train or do you wish a housebroken dog?: |
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| Are you willing to be patient and will you keep the dog/puppy should accidents happen or favorite shoes and toys get chewed?: |
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| Are you willing to attend a basic obedience or puppy class even if you have owned a dog or puppy previously? If no, why not?: |
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| How many hours a day will the puppy/dog be left alone?: |
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| If a puppy/dog is not yet house-trained, can someone stop by to let him out while you are away?: |
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| If you move from your present location, will the dog/puppy go with you to your new home?: |
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| COMMENTS - additional information you would like us to consider when reviewing your application. Please list any experience working with dogs at a shelter/rescue/daycare/fostering etc.: |
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