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Application Information

Date of Application

Name of Applicant (required)

Home Phone (required)

Email (required)

Street Address (required)

City (required)

State and Zip (required)

Referred by:

HOUSEHOLD MAKEUP: Provide the following information for all members (full or part-time) of your household.

Name.....Relationship.....Age.....Wants a Dog?.....Home FT or Work Schedule

List all pets that are currently part of your household.....Name.....Type/Breed.....Age.....Indoor / Outdoor.....M/F.....Spayed / Neutered

REFERENCES OF ADOPTIVE FAMILY
What breed(s) of dog are you considering? Tibetan Terrier/Nova Scotia Duck Tolling Retriever/Other

Male or Female:

Color:

Age:

Show Prospect (pet only or either):

Timing - When would you like to add a dog to your family?

If there is not a dog available then, would you like to be placed on a waiting list?

Any other preferences?

ENVIRONMENT: Will this dog be primarily an indoor or outdoor dog?

On average, how many hours will this dog be alone during the day?

How will this dog be confined outdoors (i.e. fenced yard, kennel, cable run, tether)?

What is the size of the area?

Do you have an inground or above ground swimming pool?

If yes, is it fenced separately from the rest of the yard?

Once trained, how and where will this dog be confined indoors when no one is home (i.e. crate, gates, doors, none)?

What is the size of the area?

Once trained, how and where will this dog be confined at night (i.e. crated, gates, doors, none)?

What is the size of the area?

PRIMARY RESPONISIBILITIES: Who will be responsible for the following activities?

Feeding:

Grooming (combing, brushing, nails, teeth, clipping):

Letting in and out (potty breaks):

Taking for walks:

Cleaning up exercise area and how often:

Housetraining:

General Training (puppy classes, obedience, general behavior):

MISCELLANEOUS

How did you become introduced to this breed and what characteristics do you find the most appealing?

Please list the dogs that you have owned in the past by breed, date owned, age of dog, what happened to him.

List the types of training in which you have ever participated (i.e. puppy class, obedience, agility, flyball, none).

REFERENCES (Veterinarians, dog training instructors, friends, relatives):

Name

Relationship

Known for how long

Phone number

Other commente

Please note:
Color: We do NOT guarantee color. We do not breed for color. We will assist you in picking your puppy based on personality with you but color will never be a consideration.
Transport: If you require your puppy to be transported, we will give you guidelines for transport in cabin on Delta airlines only OR ground transport can be arranged.
· Air transports are usually funds for the puppy PLUS the human airfare (possibly hotel)
· Ground transports are per mile from our door to yours plus tolls with a tried-and-true transporter that specializes in dog transports.

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