First Name *

Email Address *

Phone Number

Name of Pet(s) *

Street Address *

City *

State/Province *

ZIP / Postal Code *

Do you own or rent your home? *OwnRent

(If renting, do you have permission to have a pet? *YesNo

Number of adults living in the household: *

Number of children living in the household and their ages: *

Do you have other pets? If yes, please specify the type and temperament: *

Do all members of your household agree to getting a puppy? *YesNo

Who will be the primary caregiver for the pet(s)? *

How many hours per day will the pet(s) likely be left alone? *

Where will the pet(s) spend most of his time during the day? *

Where will the pet(s) sleep at night? *

Do you have a securely fenced yard? *YesNo

(If no, please describe your plans for exercising and potty breaks.) *

Your Lifestyle and Expectations:

Why are you interested in a pet? *

What are you looking for in a companion animal? (e.g., playful, cuddly, active) *

Are you familiar with the grooming requirements of a pet? *YesNo

Are you prepared for the time and financial commitment involved in owning a pet (including vet care, food, grooming, training, etc.)? *YesNo

How do you plan to train the pet(s)? (e.g., pet classes, at-home training) *

What type of activity level are you looking for in your pet? (e.g., leisurely walks, more active outings) *

Reservation and Commitment:

Are you prepared to pay the $300 non-refundable reservation fee if your application is approved? *YesNo

Are you committed to providing the pet with a loving, safe, and permanent home? *YesNo

Additional Information:

Is there anything else you would like us to know about you or your household that would help us in making our decision?0 / 180

Is there anything else you would like us to clarify for you in regards to the pet you are inquiring for?0 / 180

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