Name
*
First Name
Last Name
Email
*
Home Phone
(###)
###
####
Cell Phone
(###)
###
####
Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Names of all adults in household:
Ages of Adults in Household:
Ages of Adults in Household:
Do you live with:
How many adults (21 and older) in your household?
How many individuals under 21 in your household?
What are the ages of the individuals under 21?
Pup you are interested in Adopting (Note: Adoption fee varies)
Pup's living situation
check all that apply
Other - please specify:
How many hours a day will pup be home alone?
When home alone pup will be:
check all that apply
In a Kennel:
Tied up outside:
Pup will be loose:
If "Other" please specify:
How will you exercise the pup?
check all that apply
Please describe your past experiences at dog-parks:
Where will the dog sleep at night?
How will the dog be cared for during overnight absences or while on vacation?
Is the home in an:
Yard size is:
Is the yard enclosed by a fence?
If YES check all that apply:
If OTHER, (please describe):
Approximate Height of fencing?
Do you live in a:
Do you own the property?
If you are renting, please provide Landlord's name and phone number for verification:
If your landlord allows dogs, is there a weight/size/breed restriction?
If “YES”, what is their restriction?
Does your municipality have breed specific restrictions?
If "YES", please describe the nature of the restrictions:
Do you have other DOGS?
Check all that applies
Please specify breeds, ages, sex and name of other pups:
If you had other pups in the past, please let us know their current disposition:
Please specify what happened.
Who will be the main caregiver of the dog?
What other kind of animals do you own?
Have you ever adopted a dog before? If so, from which organization? Where is this dog now?
How will you transport the dog to places such as the vet that require car travel?
How would you discipline the dog if it misbehaved? Please describe in detail a potential situation.
What will you do if the dog gets into trouble by ruining something you value?
Have you ever taken a dog to obedience classes before? If so what was your experience like? If not, why did you choose not to?
Are you willing to housebreak a dog?
What method of housebreaking will you use, if applicable?
Do you or does anyone else smoke in the house?
List the types of behavior problems you consider NOT acceptable as everyday occurrences?
If you have a dog, what are you currently feeding it or what do you intend on feeding your new pup? Are you open to suggestions and receiving information on pet nutrition?
Additional information you would like to provide about yourself and/or the pup you would like to foster:
REFERENCES:
If you currently have any pets or had pets in the past, please supply the name and phone number of your current (or past) veterinarian, or the one who saw your previous pet(s), with their title identification. If you don't have a vet, please provide the name of your employer or anyone not related to you who can attest to your character. Vet references are required for current animal owners.
May we contact your current veterinarian to inquire about your current and prior pets’ care?
Please provide two additional personal references (name and phone number):
