Which dog are you applying for?First Name *Last Name *Partners First NamePartners Last NameStreet Address *Street Address Line 2City *State *ZIP / Postal Code *PhoneCellE-mailOccupationSpouse’s OccupationEmployerSpouse EmployerDo you live in a:HouseCondoApartmentMobile HomeMilitaryOtherHow long have you lived there? (Years/months)Do you:RentOwnIf you rent, what is your landlords contact informationAre you willing to provide adequate medical care if this dog should become sick or injured?YesNoWould you object to an inspection of your home by an ARRF representative?YesNoHow many hours a day will this dog be left alone?Where will he/she be kept during this time?Have you ever owned a cat or dog before?YesNoIf yes, what happened to them? (If deceased please state cause of death and how long ago?Do you currently own any animals?YesNonumber of cats:number of dogs:Others:Have they all been spayed/neutered?YesNoDo you have a swimming pool?YesNoIf yes, how is it fenced/covered?Do you have a fenced yard?YesNoIf yes, How high is it?What type?Do you have children at home?YesNoIf yes, what are their ages?On the first night home where will the dog sleep? (Please be specific)Who will be responsible for feeding, grooming and training your new pet?Dogs left alone frequently dig, chew and bark. How do you plan to deal with these potential problems?What will happen to the dog if you move?Under what circumstances would you not keep this dog?DivorceMoveNew BabyNew JobIllnessotherDescribeWhy have you chosen this dog?How did you learn about this dog?I CERTIFY THAT THE ABOVE INFORMATION IS TRUESignature:DateI give ARRF permission to add my email address to their newsletter list.SUBMIT
