Personal Name: |
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Address: |
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City: |
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State: |
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Zip: |
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Home Phone: |
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Work Phone: |
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Best time to
call: |
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Married: |
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Spouses Name: |
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Your Occupation: |
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Spouses Occupation: |
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Reason for Wanting Dog: |
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Does anyone in the household object to
having a dog? |
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Have you or anyone in your family ever been
convicted of an animal cruelty crime: |
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Housing: |
Type of Housing |
If renting, will your landlord /association
allow you to have a dog? |
What Size |
Landlord or Association Name |
Phone |
Does fencing completely enclose your yard? |
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If not, explain how and where you will allow
the dog to exercise and relieve itself |
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How much time do you have to exercise your
dog? |
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How much time will the dog normally be left
alone during the day? |
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Where will the dog spend the day? |
ie.. loose
indoors, basement, crate, kennel run, tied up outside, fenced yard, etc.. |
How frequently do you travel? |
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Where will the dog stay while you are away.? |
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How much time do you plan on grooming your
dog?
(bathing, nail trim, ear cleaning etc..) |
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Are you willing to provide yearly health
checkups and immunizations? |
Checkups and immunizations at $50 to $100
Emergency Care: |
Will you care for problems that develop when
the dog is older? (diabetes, arthritis, etc.). |
At what cost? |
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