DOG INFORMATION:
BREED Jack Russell Terriers, Any small dog Other specific breed &
SEX preference NOTE Males are much more available than females
__MALE __FEMALE
AGE Older dogs are much more available There are seldom puppies.
What is the OLDEST age you will accept~.______________ Any age
ABUSED: Will you accept a dog who has been abused'? (We will not adopt out any "mean" dogs) Yes __No__
___Maybe, with the following conditions _____________________________________________________ MEDICAL: Will you accept a dog who has TREATABLE medical problems? (ex needs pills)7 Yes__ No__
___Maybe, with the following conditions___________________________________________________ HOUSEBREAKING: Will you accept a dog who needs housebreaking? Yes ___ No ___
___Maybe, with the following conditions _____________________________________________________
HISTORY: Have you owned a dog before? Please provide us with a brief history of what happened to it (Unfortunately, it has been our experience that potential adopters who have never owned a dog before are not prepared for the problems of a rescue dog and return the dog, causing unnecessary trauma Therefore we do NOT adopt to anyone who has not had a dog before and a good recent verifiable vet record ) If your last dog
died, please state dogs name and date deceased
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Why do you want to adopt a rescue dog?
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HOUSEHOLD INFORMATION:
RESIDENCE: (Circle) HOME: Own - Rent CONDO: Own - Rent APT: Own - Rent Please~ note If you rent, are you permitted to have an animal Please verify with your landlord Can you have a pet,_______
Rescue application continued
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