Personal Information:
Date:
Required Applicant's Name:
Spouse's Name:
Required Street Address:
Required City:
Required State:
Required Zip Code:
Required Home Phone Number:
Evening Phone Number:
Cell Phone Number 1:
Cell Phone Number 2:
Best Number to Be Reached At :Cell 1 Cell 2 Daytime Evening
Email:
Occupation of Applicant:
Employer:
Occupation of Spouse:
Employer:
Your Family and Pets
How many adults in the home?
How many children in the home?
Ages of children:
Please describe what type of housing you have: house townhouse/condominium duplex trailer/mobile home apartment other
Do you own or rent your home?
Fenced in yard? yes
Height and type of fence:
List current pets, including age and sex:
List former pets that you have had in the last 5 years and please explain what happened to them:
Veterinarian Information:
Do you have a Veterinarian? If so, please list the name:
Your Veterinarian's Phone Number:
Have you used this vet in the past?
References:
Reference #1 Name:
Reference #1 Phone Number:
[Non Family Member] Reference #2 Name:
Reference #2 Phone Number:
Your interest in dogs:
Why do you want a dog? Companion Hunting Dog Child's Companion Other:
Please explain the type of dog that would best fit into your lifestyle:
Explain your interest in rescue dogs, if any:
Is there anyone at home with pet allergies?
Care and Training
Who will be responsible for the care of the dog?
Where will the dog be kept during the day?
Where will the dog be kept at night?
Are you familiar with the use of a crate to train and/or confine the dog in your absence?
Will the dog have the run of the house?
Will the dog be tied outside or live in the yard?
Do you own a kennel? yes
Kennel description:
Describe your dog training experience:
What books have you read on training dogs?
Do you have plans for obedience training?
What type of discipline will you use when training?
Activities you plan to share with your dog:
What will you do with your dog when you go on vacation?
If you move, what will you do with your dog?
Are you willing to care for this dog for 10 years or more? Yes No
We require that all dogs be spayed/neutered prior to adoption; do you have any questions about this policy?
If you are unable to care for your dog in the future, who will accept responsibility for its care?
In what type of vehicle will you transport your dog?
We try to follow up on the welfare of our adopted dogs. Can we visit or call upon you after the adoption?
Dog Preferences:
Gender Preference: -please choose- male (neutered) female (spayed) either
(All dogs are spayed/neutered prior to adoption.)
What color dog are you interested in? -please choose- black yellow chocolate no preference
Please tell us the age of dog that interests you:
(dogs have a longer puppyhood due to their outgoing natures and one can expect puppylike behavior until about 2 years old )
check all that apply less than 6 months old 6 to 12 months old 12 to 18 months old 2 to 3 years old 4 years old or more no preference
Temperament: -please choose- active moderately active gentle/not active
Do you have any special needs or wants?
Dogs listed on our site that you are interested in:
How did you hear about KLR?
Credit Card Information:
