Is the home in an Urban, Suburban, or Rural setting?
Yard size is: Small,
Medium, Large, Multiple Acreage, No Yard
If you move in the future, what will you do with your dog?
How many adults are in your household? Children?
Ages of household members:
Please select YOUR age range:
By checking YES you agree that any dog adopted from K9 Rescue Ltd. will not
be used in any illegal activities nor be found at any time in a municipality where Pit Bull presence is illegal. YES NO
By checking YES you agree that any dog adopted from K9 Rescue Ltd. will be kept
as a house pet. It shall not be used for medical or any other experimental
purpose, and it shall not be used for breeding. YES NO
Do you currently have any other dogs? YES NO
If yes, please list breed(s), age(s) and whether spayed/neutered or not:
What other pets, if any, do you own?
Dog's living situation, (check all that apply):
Dog will be house pet, living inside with family Dog will live in
basement or garage
Dog will live outdoors Doghouse provided Guard Dog for ...Business Residence
Other - please specify:
If outdoors, what kind of facilities or shelter do you have available?
How will you exercise the dog? (check all that apply)
Leash Walk every day Will have Cable in the yard Will be free to run in Fenced Yard
Will be free to roam around (off leash and unsupervised in an unfenced area)
Will bring to Dog Park (Enclosed public area where all dogs are allowed to run and play off-leash)
Other:
Do you have a fenced area (e.g. a fenced yard or adequate dog run) for your dog to exercise? YES NO
If yes, describe (please include type of fencing and height, whether covered, etc.):
If no, are you willing to walk your dog, on lead, at least 2 to 3 times per day? YES NO
How many hours a day will dog be home alone?
Where will the dog be during this time alone?
Will more than one pet be left alone, unsupervised, during your absence?Yes No
Are there any breed restrictions and/or legislation in your city, county or state? YES NO Don't
know
If so, please describe the nature of the restrictions:
If you had other dogs in the past, please let us know the current disposition of those dogs:
Died of old age
or fatal disease Was hit by a car,
stolen or lost Gave
or sold to friends, relatives or acquaintance
Please give the reason(s) and/or circumstances:
Experiences: Please relate any prior experience you have had with this breed:
References: Please list 3 references, including name, full address (including city, state and zip code), phone number and occupation. If you currently have a dog (or had one in the past 3 to 5 years), then one of the references MUST be your current veterinarian or the one who saw your previous pet(s).
1)
2)
3)
How far can you drive to pick up the dog?
If needed, are you able to pay shipping expenses? YES NO
Please list anything else that you think might be of interest as to your history, experience or interests regarding dogs: