Bentley Farms Great Dane Rescue
This form is designed to help find dogs a compatible lifestyle and home. Completing this application does not guarantee an adoption of a Bentley Farms Dog. In order to be considered as an adopter you must: 1) Be 21 or older 2) Have a valid drivers license or government issued ID 3) Have knowledge and consent of your landlord if renting 4) Be willing to provide proper care, training and medical treatment 5) {If chosen} Pay a rehoming fee if applicable -fees are based on dogs medical needs and boarding time 6) Provide references and a copy of your drivers license
Adoption Application
Bentley Farms Great Dane Rescue 2150 Valley Burg Rd. Luray, VA
Dog's name you are interested in
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
-
Area Code
Phone Number
Can we text you?
yes
no
Email
example@example.com
Occupation
Work info
Employer
Employers address/ Phone number
Number of children in the household
1
2
3
4
5
6
7
8
9
Age of children
Number of adults in the household
1
2
3
4
5
6
7
8
9
Is anyone in your home allergic to pet hair
Who will be the primary caregiver for the new dog
Do you rent or own
own
rent
Other
Landlord's name and phone number
What type of housing do you live in
house
apartment
condo
Other
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Do you have a pool? is it fenced in? explain
Do you have a completely fenced in yard? explain
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Do you have other pets? list below age/breed and sex? Are they spayed or neutered?
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Which of the following behaviors would be a serious problem for you
digging
jumping
pulling on a leash
not getting along with cats
not getting along with dogs
Not good with children
not house trained
too active
too big
shedding
anxiety being left alone
Other
Why are you searching for a new dog and what qualities are you looking for?
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Where will the dog be kept when it is alone
Will the dog be kept inside the home
If you vacation or travel , who will care for the dog
Where will the dog sleep
How often will the dog be exercised
How many hours a day will the dog be left alone
Is this your first dog
yes
no
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Have you ever surrendered an animal to a shelter- if yes, explain
List other references- name, email and contact number
Veterinarian name, address and phone number
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Are you willing to have a representative from Bentley Farms visit where the dog will be living
yes
no
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Submit
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