FENCE Do you have a fenced area on your property? ___ YES ___NO if you have no fence, how do you plan to have the dog relieve itself__________________________________________
WORK: Do all adults work full time~ ___YES ___ NO
ALONE: How many hours each day will your new dog be alone? Alone _________ hours
Where will the dog be kept when it is alone? _________________________________________
PEOPLE: List below all people who currently live at this residence.
Full Address to be listed below
______________________________________________________________
_______________________________________________________________
Full Name of Adults + Ages - -- Adults/ Children
______________________________________________________________
_______________________________________________________________
Name + Age of Children in the household - -- Adults/ Children
______________________________________________________________
_______________________________________________________________
Phone number of Residence
______________________________________________________________
ANIMALS: List below any cats, dogs, etc who currently live in your household:
/Breed Name Sex / Neutered/ Ages How Many/ Owned? Kept where?
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
ALLERGIES: Does anyone in your house have any known allergies to dogs'? ___NO ___YES
REFERENCES
VET REFERENCES. Please provide the contact information of a veterinarian you have used before and plan to use with your new dog? Vet references are checked. (Ifyou do not have good recent vet references, We cannot adopt to you)
NAME
PHONE (MUST include)( )___________________________________________
Vet records are under the name of________________________________________________
EMPLOYER: Please list place of employment for yourself and your spouse, if applicable
Rescue application continued
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