Deez Louise Dogs

Deez Louise Dogs

Application
Please complete the following information to the best of your knowledge
Your Name*
Email Address*
example@example.com
Address*

Address Line 2

Street Address Line 2

CityState / Province

Postal / Zip Code
State / Province*
Postal / Zip Code*
Phone Number*
Secondary Phone Number*
Animal(s) interested in adopting*
Would this be your first pet?*
What type of dwelling do you live in? Do you rent or own your home? If you rent provide your landlords name & phone number. *
How long have you lived in your current home?*
How many people live in your home?*
Do you have any children living in your home? If so what are the ages of the children.*
Are you employed? If so, where?*
Will your pet be inside, outside or both? *
Please list any animals you've had in the past five years (include names, type of pet. breed, age, gender, spayed/neutered status, indoor or outdoor pets)*
How many animals do you currently have?*
Who is your current Veterinarian (name/phone)? If you do not have a vet, who do you intend to use for this pet? *
Whose name is the account under at your veterinarian?*
Are you animals up to date on vaccines? If not, please explain why. *
Are your animals spayed/neutered?*
What are the names of your current pets?*
Reference #1: Please provide the name and phone number of a personal reference (who does not live with you).*
Reference #2: Please provide the name and phone number of a personal reference (who does not live with you).*
Have you ever been convicted or charged with animal cruelty or neglect If yes, when?*
What is it about this particular animal that draws your interest?*
Where and with whom will your pet spend most of his/her time?*
If your adopted animal has behavioral issues, how will you deal with those? (What if s/he claws your furniture? Gets on surfaces you do not wish them to jump on? Nips at your hands too hard? Chews on shoes, etc.?)*
Is there anything else you would like to let us know?
Adopter Signature*

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