Application
Please complete the entire application.
Please make sure the email address and phone numbers provided are correct!!
Name:
Address:
City:
State:
Zip:
Home Phone: Preferred Contact Method:
Work Phone:
Cell Phone:
Email Address:
With whom are you/spouse employed and how long have you worked there?
Which breed of dog are you interested in?
Is there a particular dog on our website that you are specifically interested in? (Also, please specify gender - Male/Female/Either)
Age desired:
Acceptable Age Range:
Would you consider a special needs dog such as one who requires medication for a controlled condition?
Would you consider a dog who needs obedience training?
Are you familiar with the breed you are wanting?
Members of household and their ages:
Do they share your interest in adopting/buying your dog?
Who is your dog for?
Please list all the pets you have owned in the past three years. Please list Species, Sex, Age, Spayed/Neutered, and what happened to each pet.
Please provide name, address, and phone number for your current veterinarian?
How long have you lived at your current address?
Do you own or rent?
House, Apartment, or Condo:
How long daily will the dog be left alone (without people)?
Where will the dog sleep at night?
Are you familiar with the use of a dog crate to train the pet during the time you are away or asleep at night?
Is your yard fenced?
will the dog be walked daily?
Allowed to run free outside of fence without supervision?
Have you ever owned a dog??
Are you aware that routine costs of owning a dog average $800 a year?
Have you sold, given away, or surrendered a pet?
If yes, please specify the circumstances:
Please tell us why you want a dog:
How did you find out about this website?
Has any member of your household ever been cited for leash law violations, animal cruelty, and/or abandonment of animals?
If yes, please specify:
Are you currently working with or have you contacted or adopted from another rescue group? If yes, please tell us which group(s).
I attest that I am of legal age (minimum of 18 years old) to be bound by a contract and that the information provided on this application is true and accurate to the best of my knowledge. I understand that prior to the placement of a dog in my home, the above information may be verified. I also understand that completion and submission of this application does not guarantee the adoption or buying of a dog.
Applicant's full name:
Date
Please e-mail this forum to me at perfectpal714@yahoo.com
