First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

Email*

Home Phone*

Work Phone
x

Cell Phone

Are you applying to foster or adopt?*

What dog(s) are you interested in?*

Do you live within our 1,000 mile transport radius? (Distance between your home and the dog's location)

If you are within transport distance are you able to drive at least the last leg of the trip? A "leg" is usually 75-100 miles

If you are over 1,000 miles, are you able to drive the mileage in excess? *

Why are you interested in adopting a pet at this time*

Have you applied with any other rescue*
Choose one: Yes No

How did you hear about us*

What is your age?*

What is your occupation?*

How many hours per day are you away from home?*

Are you married? Partnered?*
Choose one: Yes No

Name of Spouse or Partner, if applicable. If not married or partnered, please answer NA*

What is your spouse/partners occupation?*

If married, how many hours is your spouse gone per day?*

How many ADULTS reside in your home? *

Ages of other adults in home (spouse, partner, roommate, etc.)

Are there any other people living on the property or in the home? (renters, tenants, roommates, family members, ranch hands, etc.) If yes, please list all people that would have contact with this dog: *

How many children are in the home? What are their ages?*

Do children under 5 years old regularly visit your home?

Who in the household will care for the pet*

If you become unable to care for your dog, or, if you pass away, who will care for your dog?*

I would best describe my activity level as being

In what type of home do you live*
Choose one: Single Family Duplex Apartment Townhouse Condominium Mobile Home Military Housing

Do you own or rent your home*
Choose one: Rent Own

Are you planning on moving within the next year?*
Choose one: Yes No

If you rent, have you received the approval of your landlord to have an animal
Choose one: Yes No

Is your neighborhood considered urban, suburban, rural or semi rural?*

Is your yard fenced? *
Choose one: No Yard Unfenced Yard Yard Completely Fenced Invisible Fenced

What type of fence do you have? *
Choose one: Chain Link Wood Privacy No Climb Welded Wire Other Livestock Fencing Barbed Wire Invisible Fencing Wrought Iron Other

What is the height of the fence? PLEASE MEASURE if you are uncertain of height*

If you answered "other" for previous question, please specify and/or describe what type of fencing you have.

How much time will the animal spend alone during the day*

Where will the animal be kept when you are not home*

Where will the animal be kept when you are home*

Will you be crating this dog? If yes, for how long and when (bed time, during the day, etc.)*

Please list all dogs currently in your home NAME AGE GENDER BREED SPAYED? NEUTERED?*

Do you have cats? If yes, will the dog be in contact with them?*

If you have livestock, please tells us which of these animals you own.

What animals will the dog be in direct contact with?

If this is a working dog, what type of shelter will the dog have?

Have you ever owned, or do you currently own an Anatolian?

Please list dogs you have owned in last 10 years, how long they lived with you and what happened to them.*

Have you ever given up a pet? If yes, please explain*

Gender Preference

Your ideal size of dog would be

I prefer a dog whose energy level is

Grooming/Shedding Preference

I prefer a dog whose training needs are

I prefer a dog who is compatible with

Describe how you will train the pet*

Veterinarian's Name and Phone Number*

Do you use a flea and tick preventative? If so, what product do you use and how often?*

Do you use heartworm preventative?

What heartworm preventative product do you use?

If you answered "other" for heartworm preventative product please list the name of the product(s) you use.*

If you do not use any heartworm preventative for your dogs please explain why.*

I certify that the information entered on this applicant is true. Enter your name and date*