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Applicant's Name
Address
City, State, and Zip
Home Phone
Cell
Work
E-mail
Do you
own
rent? Landlord Name
Landlord Phone
Fenced yard?
YES
NO If no, how will the dog be exercise?
Where will the dog sleep?
Children?
YES
NO If yes, ages
Are you or anyone in the household allergic to animals?
YES
NO
Other pets
Place of Employment
How long at present job?
If less than a year, please provide previous employer
Work Hours
Co applicant name and work hours
Veterinarian's name (for current or previous pets)
Phone number
Kennels or pet sitters used in the past
Personal References: Name
Phone
(non-related) Name
Phone
Name
Phone
Have you ever attended obedience classes with a pet?
YES
NO Where?
Are you a member of any dog-related clubs?
YES
NO Names
What happened to previous pets?
Have any been surrendered or given away
YES
NO
Circumstances?
PART 2 - DOG PREFERENCES
Dogs from Monty's Home Pawsitive Partners Prison Program are rescued from local animal shelters.
Although exact breed is unknown we do want to match the type of dog you prefer to one in our system by
answering the following questions. |
What breed of dog would you purchase if you were to buy a dog? 1.
2.
3.
If no specific breed: Size / Weight
XS
Sm
Med
Lg
XL
Hair Length:
Long
Short
Gender
Male
Female
Doesn't matter Age preference
Energy level of your new pet would best be described as:
What activities do you want to share with your new dog?
What training goals do you have for your new pet?
Are you interested in therapy dog training and certification?
YES
NO
To you, what is the ONE most important thing about your pet?
The least important?
Additional comments regarding preferences or concerns with your adoption:
Please Print a copy of the application prior to submitting. Thank you!
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