First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

Email*

Home Phone

Work Phone
x

Cell Phone

Text/Pager Email

List age for all household residents who will be living with the dog, including both children and adults.*

Applicant Address, City, State, Zip*

Please list all current types of pets that live in the home, name, age, sex of each and every pet, or write NA if no other pet in the home. (NOTE we do NOT adopt/foster male Dobermans into homes with other male Canines due to dangerous dominance issues.)*

Please list current employer and length of time at current job:

We do require formal training with your newly adopted pet for the social and bonding aspect, plus you can always learn better ways to train from trainers and pet owners. Include all formal classes previously taken and trainers you have worked with in the past or are planning on working with in the future.

Are your current pets spayed or neutered? *

Are all current pets, dogs and cats, up to date on vaccines, heart worm preventative and spayed or neutered? What was the last date of their vet visit? In the alternative, approximate date of last veterinary visit.*

Please list name, address and phone number of your current and past vet here. Please notify your vet we will be calling to verify your vet care. We do require your current and past pets to be altered, current on vaccines and on monthly heartworm preventative. If no vet write NA.

Have you ever surrendered or given away a pet you have owned in the past? Explain*