Rescued Dog Application

We appreciate if you can please fill out the following application for the rescue dog you are considering.

PLEASE make certain that you provide a valid email address (Double Check what you write) - or we may not get back to you.

We will get back to you via email or telephone as soon as possible.

Please answer the following questions, then hit "Submit" when you are done.  Thank-you.

  1. Please provide the following contact information:

    Name
    Spouse's Name
    Occupation
    Street Address
    Address (cont.)
    City
    State/Province
    Zip/Postal Code
    Country
    Work Phone
    Home Phone
    E-mail - REQUIRED

  2. Who will be the primary care giver for this dog?

  3. How many adults reside in the home where the dog will stay?

  4. How many children age 6-18 live in the home?

  5. How many children 3-5 live in the home?

  6. How many children 0-2 live in the home?

  7. Do all adults agree to the acquisition of this dog?

    Yes
    No

  8. Are there any individuals in the home with an allergy to dogs?

    Yes
    No

  9. Have you ever owned a dog before?

    Yes
    No

  10. What happened to your last dog?

  11. How often will children age 9 or older be responsible for the dog's care?

  12. How often will children under age 9 be responsible for the dog's care?

  13. How many other "inside" dogs do you own now?

  14. How many other "outside" dogs do you own, now?

  15. List the breeds, ages and gender (including spayed or neutered) of the dogs you own now:

  16. How many cats are in the home?

  17. How many daytime hours will the dog be home alone?

  18. How many evening hours will the dog be home alone?

  19. Are you familiar with the use of a crate for managing a dog?

    Yes
    No

  20. Are you in favor of / willing to use a crate to manage a dog?

    Yes
    No

  21. Besides for potty breaks, where will this dog be kept during the daytime?

    Indoors
    Outdoors

  22. Besides for potty breaks, where will this dog be kept during the evenings?

    Indoors
    Outdoors

  23. If left indoors without supervision, how will this dog be managed?

    In a crate
    Loose in house
    Confined to a room
    Other - specify below

  24. If left outdoors without supervision, how will the dog be managed?

    Tied out
    Kennel / Pen
    Run loose
    Fenced Yard
     No unsupervised outdoor time
    Other - specify below

  25. How will the dog be exercised outdoors?

    Tied out               Run loose              Fenced yard            Kennel / pen         
Walk on lead           Other - specify below

  26. When you go out of town or on vacation, who will care for the dog?

  27. Do you foresee any life changes in the next 5-10 years that would prevent you from keeping your dog? What would that be?

  28. Which of the currently available rescue dog are you interested in acquiring.


  30. Please explain why you are interested in this specific dog:

  31. If the specific dog you are seeking is no longer available, would you be interested in another dog that may become available, and if so, please define that dog (breed, size, gender, activity level etc):

  32. Choose any of the activities that you plan to do with your Dog:

    Just Hanging Out  Frisbee Competitions   Obedience                  Agility                  
Tracking                   Flyball                    Camping                    Search & Rescue

  33. List any other activities you plan to do with your dog:

  34. Have you ever trained a dog before? If so, please briefly describe the methods that you used.

  35. Are you willing to take this dog to an obedience class in your area if you feel that you need to continue his training in a formal / organized setting?

    Yes
    No

  36. Do you currently have a Veterinarian? If so, please list name and practice.

  37. Would you be opposed to me contacting your Veterinarian for a reference?

    Yes
    No

  38. Do you understand that you will need to maintain your dog's training through daily practice, and you agree to do so?:

    Yes
     Not certain I will be able to do that

  39. Do you understand and agree that if you cannot keep your dog for any reason, you will need to bring him back to DarnFar Ranch at your own expense?:

    Yes
     No

  40. What is the best way to contact you?:

    Telephone                       email

  41. Do you agree to maintain this dog's health and overall well being through routine visits with your veterinarian, by providing the dog the physical and mental exercise it requires, and maintaining its socialization and training through daily practice?

    Yes
    No

  42. Please provide the details to any "Other" option you chose in an above question and/ or provide any additional information you would like to share about acquiring this rescue dog:

     

DarnFar Ranch.
Copyright © 2007 [DarnFar Ranch]. All rights reserved.
Revised: 02/15/10

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