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Name:

Phone Number:

Email Address:

Address:

City, State, Zip code:

Do you rent or own?
 Rent Own

If you rent, please provide contact information for your landlord:

Does your home have any pet restrictions?
 Yes No

If yes, what are they?

How many people are currently living in your home? What are their ages?

Is anyone allergic to pets in your household?
 Yes No

Do you have a fenced in yard?
 Yes No

What is your daily schedule like? How many hours will the dog be without supervision each day?

If all members of the home work full-time, will you have someone come to your home to help care for your pet(s) during the workday?
 Yes No

Please list any pets you’ve owned in the last 5 years, including age/weight/temperament for living pets:

If you had any pets in the last 5 years, were they housed inside or outside of your home?

If you have other pets, are they current on vaccines, heartworm/flea prevention, and spayed/neutered?
 Yes No Not Applicable

If no, why not?

Are you ready to make a lifelong commitment to the safety and welfare of your adopted pet which could be up to 15 years?
 Yes No

If at any time you become unable to care for your pet for reasons including moving, issues regarding training and/or socialization, or another reason, do you have a plan in place (other than surrender to a shelter) for the pet? If so, what is the plan?

Have you surrendered a pet before? If so, what was the reason?

Under what circumstances would you would you surrender your pet to a shelter or rescue?

What are the most important characteristics you are looking for in a dog?

What behaviors concern you the most?

How would you respond to a dog that growls at another dog or visitor? How will you help your new pet and current pet interact? What will you do if they do not get along at first?

Are you willing to spend resources and time with a trainer if your pet develops behavior issues?
 Yes No

Will you crate the dog while you’re away or as part of his/her training?
 Yes No

How do you plan to train your dog? What methods will you use?

Are you willing to have someone representing our organization visit to see where the pet will be living?
 Yes No

If no, please explain:

Please provide the name of your vet and their contact information. If the information is under a name other than your name, please provide that information.

Please provide at least two references including name and contact information:

How did you hear about Angel’s Hope?

Signature:

Date: