Van

Home Type*
Home owned?*
- Yes
- No
Home Owners' Association Approves Breed and Number of Pets?*
Pet Deposit
Number of adults in home*
Number of children in home*
Age range of children*
Any members of the home allergic to dogs?*
- Yes
- No
Does every member of the home want to adopt this dog?*
- Yes
- No
Number of dogs currently in home*
Number of cats currently in home*
Where will this dog stay most of the time?*
Fence Type*
Fence Height (whole feet)*
Please enter a number from 1 to 10.
Where will this dog be while you are gone during the day?*
Hours per day this dog will be without supervision (whole hours)*
Please enter a number from 1 to 24.
Where will this dog sleep at night?*
List three behaviors which would warrant correction for this dog, in your home*
How will you correct poor behavior of this dog?*
Daily and weekly activities with this dog will include:*
- Walking/Hiking
- Running
- Playing Fetch
- Yard Work
- Dog Park
- Car Rides
- Dog Day Care
- Watching TV
- Obedience Training

Alternate Caregiver First Name
Alternate Caregiver Last Name
Ever moved without taking your pet?*
- Yes
- No
Reason for moving without your pet*
Nights per year of overnight travel (whole nights)*
Please enter a number from 1 to 365.
Will this dog travel with you?*
Where will this dog stay when you are traveling?*
Estimate what you expect to spend annually for this dog (dollars)*
Food, routine vet care, heartworm/flea prevention, toys, treats, bedding, training, and equipment, but excluding Emergency Care.
How many dogs have you owned in the last 15 years?*
How many cats have you owned in the last 15 years?*
What happened to past pets?
- Natural Causes
- Lost - Missing
- Lost - Separation/Divorce
- Accidentally Injured or Killed
- Willfully Injured or Killed
- Euthanized - Other