Why are you interested in this dog, or type of dog? Please, explain.

Which Gender would you prefer?     Male       Female

Why the above gender choice?

Preference in age? And why?

Color Preference; type of ears, tail, etc.


Will dog be a Housepet?       Hunted?     
Competed (include type)?


Will you do obedience with your dog?
Other type of training? Please explain?


Have you ever owned this breed of dog before?     Yes       No

If yes, please tell us about the dog.


Do you currently own a dog?     Yes       No

If yes, please tell us about the dog (include gender and age)


If No, what happened to it?


If it passed on, how, and at what age?


Other breeds previously owned?

If no longer owned, what happened?


If still owned, what gender, age?


Other current pets, please include birds, gerbils, rabbits, cats, etc. Please be specific - some of our dogs are good with other pets and some are not.


How far would you travel for a dog?

Time limit in search for dog, if any?

Please give your age*

Do you have any children?*    Yes       No

Ages

Are you planning on having children in the future?    Yes       No

If yes, how may this affect the dog's future?


Is aquiring a dog a family (including roomates, future spouses, etc.) decision?


How would non-acceptance of the dog by a present or future family member affect the dog's life? Please, explain.


Should your current family situation change, how would/could this affect
the dog?


Should you relocate, what would you do with the dog?


Do you currently       Own your home       Rent your home

If you rent, may we contact your landlord?    Yes       No

If you rent, please, give your Landlord's phone number.


Is someone home during day?    Yes       No

How much time would the dog be left alone daily?


If no one home on a regular basis, will someone take time off when the dog first arrives?


If no one home on a regular basis, what arrangements will be made for dog?


Where will dog live and spend most of the day?


Where will dog sleep?

How and where will dog be exercised on a daily basis?


Do you have a yard?    Yes       No

Size of yard?

Fence?    Yes       No

Type? Please be specific

Height?

Are you willing to install actual fencing, or build a safe run to protect dog?
Yes       No

Do you have a crate? Yes       No

Willing to purchase one?   Yes       No

Willing to use one?   Yes       No

If No, please explain.


Current or prior veterinarian for reference (current address and phone#)


May we contact your veterinarian?   Yes       No
If No, please, explain.


Second reference (please give contact information):

Will you deal with health issues, if the dog needs special care?
Yes       No

If No, please explain.


What would you consider the limitations for medical care to be?

Do you intend to be a single or multiple dog family?


Is there any reason, that you could think of, why you may ever have to
part with your dog(s)? Please explain.


Would you (and your family if applicable) be available for a home visit with a rescue volunteer?
      No


Please feel free to add any additional comments, that you think may help us to assure that one of our dogs may be right for you.

How did you hear about us?