YOUR INFORMATION
Your Name
*
Full Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Email Address
*
example@example.com
Age
*
Back
Next
Luxridge Airedale Terriers – Puppy Application Form
YOUR ENVIRONMENT
Do you live in:
*
Do you have a fenced yard?
*
Yes
No
Back
Next
YOU, YOUR FAMILY & YOUR PETS
Number of people in your household:*
*
Do you have children?
*
Yes
No
If yes, what are the ages of your children?
Expecting a child soon?
*
Yes
No
Pregnant
Activity level - would you describe yourself? As:
*
Very active
Moderately active
Not very active
Is this your first dog?
*
Yes
No
Is this your first terrier?
*
Yes
No
Is this your first Airedale?
*
Yes
No
Do you have other animals?
*
Yes
No
If yes specify breed(s) and temperament (e.g. fearful, submissive, dominant)
Back
Next
Your interest in an Airedale
Why do you want to adopt and an Airedale?
*
In a few sentences, explain why we should consider your application as future adopters.
*
What do you expect from the puppy you want to adopt? (Check all that apply)
*
Loves children
Gets along with other dogs
Gets along with cats
Playful and energetic
Calm
Accepts being left alone
House trained
Sociable with strangers
Comfortable in the city
Quiet in the car
Has hunting instincts
Enjoys dog sport
Other
How many hours will the dog be alone during the day?
*
Rarely
2-4 hours
4-8 hours
Will you use a crate during absences and at night?
*
Do you agree to allow us to follow up with you by email and or phone regarding the puppy or dog?
*
Yes
No
Do you agree to notify us immediately and as a priority in case of health issues, ear carriage correction, behavioral issues, change in family situation etc?
*
Yes
No
Have you ever had to euthanize an animal?
*
Yes
No
If yes, why?
Have you ever had to rehome or give up an animal?
*
Yes
No
If yes, why?
Would you be interested in adopting an older dog?
*
Yes
No
Are you an Airedale breeder or have you ever been involved in the breeding?
*
Yes
No
If yes, please explain
And Airedale can live 10 to 13 years. Are you prepared to commit to caring for your dog for its entire lifetime?
*
How did you hear about our kennel?
*
Internet search
Instagram
Facebook
Canadian Kennel Club
Ottawa Kennel Club
Friend or acquaintance
Other
If a friend or acquaintance, please provide their name:
Submit
Should be Empty: