ADOPTION APPLICATION

We appreciate your interest in our breed. Please complete the following so that we may know you better. Copy/Paste to email and send to address listed below.

Date:   ___/ ___/ ___
Name _________________________________________
Address:
___________________________________________________________________________
____________________________________________________________________________
________Home phone   __________________________
Work phone  __________________________
Email address    _____________________________________________
Best time to be contacted
______________________________________________________________
How did you hear about us?
___________________________________________________________

Please specify breed/breeds interested in and why:
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____________________________________________________________________________
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____________________________________________________________________________
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Do you consider yourself / family to be active? _________

Describe:
____________________________________________________________________________
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________________

What dogs do you currently have (breed, age, sex)?
____________________________________________________________________________
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____________________________________________________________________________
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Have you had?
____________________________________________________________________________
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What happened to those dogs?
____________________________________________________________________________
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How do your dogs get along with other dogs?
____________________________________________________________________________
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Is / are your dog (s) spayed/neutered?
____________________________________________________________________________
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Ever train in obedience? Yes/No
Willing to train in obedience?   Yes/No

Own cats? Yes/No
Are they used to dogs?  Yes/No
Do they live indoors?  Yes/No

Name, address and phone number of your
veterinarian_______________________________________


Size of yard?
________________________________________________________________________

Fenced?  Yes/No
Height __________________
Fence type _________________________
Enclosure attached to house? ________________
Yard completely enclosed? __________________________
What kind of shade is in the enclosure?
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What kind of accommodations do you have for the dog in the cold?
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Anyone home during the day?
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Hours dog would be left alone
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Where would the dog stay during the day when alone?
______________________________________
Will the dog be allowed to live inside?  Yes/No

Where will the dog sleep?
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Do you have a dog door into the house or garage?
___________________________________________
Do you own / have a dog crate?  Yes/No
What do you do with your pets when you go on vacation?
_____________________________________


Ages of children in contact with dog
______________________________________________________
Any asthma or allergies in household to dogs or cats?  Yes/No

Describe neighbors that dog will be involved with… (Do they like dogs? have
children? have dogs, cats?)
____________________________________________________________________________
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Any problems currently with neighbors? Yes/No

Explain
____________________________________________________________________________
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Do you own your home?  Yes/No
If not, do you have permission from landlord to own dogs there?
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Please specify what age / sex / color /breed of dog you are looking for (if
you have a preference)
____________________________________________________________________________
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Do all parties (if there is more then one adult in household) want a Dog?
_________________________

Any questions about the breed that we may answer for you?
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Adopted dogs need an adjustment time, are you willing to give the new dog at
least a month trial to ensure proper adjustment? Yes/No

What in your opinion would constitute a reason for not keeping the dog?
_________________________
____________________________________________________________________________
________

Would you consider a second Dog in the future?  Yes/No

We are always in need of temporary homes for our rescue dogs, would you be
willing to foster a needy Dog if it is compatible with your lifestyle and
pets? Yes/No
For how long? ___________________________________________________________

By signing this questionnaire you acknowledge that completion of this form does not guarantee that we will place a Dog with you. You must first pass our interview, our home inspection and complete one of our Adoption Contracts including at least 1 post adoption home visits for the purpose of checking on the dogs well being. We reserve the right to terminate the adoption process at any time.

Sign here ___________________________________________________
Date ____________________