PET REQUEST
HEALTHY PET OWNERSHIP
Owner Name
Email
example@example.com
Pet Information
New vs. Existing Pet?
New Pet
Existing Pet (Owned before joining staff)
Pet Name
Pet Species
Dog
Cat
Other
Pet Breed (If known)
Pet Size
Small Pet 1 - 20 lbs.
Medium Pet 21 - 60 lbs.
Large Pet 60 + lbs.
Pet Age (If known)
Behavior Assessment
BEHAVIOR WITH PEOPLE: Which best describes your pet's behavior with people?
Timid or Fearful
Shy and avoids contact
Gentle or docile
Friendly and calm
Excited and playful
Physical and rough
Aggressive or intrusive
Harmful or violent
BEHAVIOR WITH ANIMALS: Which best describes your pet's behavior with animals?
Timid or Fearful
Shy and avoids contact
Gentle or docile
Friendly and calm
Excited and playful
Physical and rough
Aggressive or intrusive
Harmful or violent
SPECIFIC BEHAVIOR: Select ALL behaviors that the pet has shown with people.
Begging
Food aggression
Growling
Barking
Running up to greet
Lunging
Chasing
Jumping
Herding/Knipping
Biting
What is your pet's typical noise level?
Silent
Soft
Moderate
Loud
Excessive
TRAINING: What behavior training does your pet have?
Basic commands
Recall
Barking control
Potty trained
Certified service animal
Any comments about your pet's behavior that would be helpful for us to know?
Pet Alterations
Is your pet altered? (fixed/spayed/neutered)
Yes
No
Does your pet have all required vaccinations required by the state of California?
Yes
No
Owner Agreements
I am fully committed to serve the Lord at Gleanings with or without this pet.
Yes, I agree
No, I do not agree
I am committed to approach all issues surrounding pet ownership with prayer, humility, trust, and submission.
Yes, I agree
No, I do not agree
I am prepared to re-home my pet during my staff commitment if the pet is or becomes unfit for the Gleanings community.
Yes, I agree
No, I do not agree
I am committed to make all necessary changes or improvements to maintain healthy pet ownership.
Yes, I agree
No, I do not agree
I have read and agree to Gleanings' Pet Policy "Healthy Pet Ownership".
Yes, I agree
No, I do not agree
If approved, I authorize Gleanings to withhold the "Valued Pet Fee" of $5/month/pet
Yes, I agree
No, I do not agree
SUBMIT
Should be Empty: