Canine Angels Career Change Dog
Canine Angels Service Teams
13475 N. Applegate Rd.Grants Pass, OR. 97527888 K9 ANGLS or 541 846-6400www.Canine-Angels.org email: info@Canine-Angels.org
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
example@example.com
Phone Number
-
Area Code
Phone Number
Is there anyone in your household with special needs?
Do you own or rent your home?
Own
Rent
If you rent, do you have your landlord's permission to have a dog?
Yes
No
Landlord's Name
First Name
Last Name
Landlord's phone
-
Area Code
Phone Number
Your occupation
Spouse or partner's occupation
Is someone home most of the day?
Yes
No
Where will the dog go when you're not home?
Will you be leaving the dog alone a lot?
Yes
No
What is your dog experience? (breeds of dogs you have previously owned, obedience classes taken, etc)
Please list names and relationship of all people living in your home and ages of minors:
Please list all household pets and livestock, including species and ages:
Vet's Name
First Name
Last Name
Vet's Phone
-
Area Code
Phone Number
Do you have a breed preference?
Yes, I prefer the below selected breed, but I will take any dog that is a good fit for my family
Yes, I will only take a specific breed, see below
No
I prefer the following breed:
Golden retriever
Labrador
Lab/Golden X
Poodle
Goldendoodle
American Indian Dog
Do you have a color preference?
Not really
Chocolate
Black
Yellow
Do you have an age preference?
1-2 years
3-5 years
Retired
Unimportant
Do you have a gender preference?
Male
Female
Unimportant
Are you prepared to take a dog now?
Yes
No
Approximate ready date:
Is there anything else you'd like us to know?
Submit
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