Full Name
*
First Name
Last Name
E-mail
*
Phone Number
*
-
Area Code
Phone Number
What type of phone line is this?
*
Home
Cell
Business
Other
Phone Number 2
-
Area Code
Phone Number
What type of phone line is this?
Home
Cell
Business
Other
What would be the best time to reach you by phone?
Example: 12am-12pm
Reference Phone Number (Personal or Veterinarian)
*
-
Area Code
Phone Number
State
*
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
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Texas
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How did you hear about Educated Rescue Dogs?
Google
Personal Referral
Viral Referral
Other
Which of the available trained dogs are you interested in taking home?
Dogs Currently Available: Friday, Juda, Kubota, Enzo
Do you have any other dogs in your home?
Yes
No
Please give us more information on your current dog(s); size, tempermate, and any other important information.
Do you have any other animals in your home?
Yes
No
What type of animals?
How many adults are in your home on average?
Is there any children present in your home?
Yes
Sometimes
No
What are their ages?
From
To
Who will be the primary caretaker of the dog?
Do you have a fully fenced backyard?
Yes
No
Please describe your fence, how tall is it and what material is it made of?
On average, how many hours will your dog be alone throughout the day?
Where will your dog primarily be?
What types of activities will you be doing with your dog?
On average, how many hours of exercise will your dog get?
Where would you like your dog to sleep?
What type of surface would your designated potty area be?
Grass
Gravel
Concrete
Dirt
Artifical grass
Will there be long periods of time that your dog will be alone, such as when you're on a vacation?
Yes
No
Is there any specific training you'd require in a dog?
Would you be willing to pay medical costs if the dog requires it?
Yes
No
Would you be interested in a referral to specialized training, such as agility training, fly ball training, or schutzhund training?
Yes
No
Thank you for completing the Available Trained Dogs form. Educated Rescue Dogs will evaluate your submission and contact you.
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