Copyright © 2007-2008 by New Beginnings Shepherd Rescue   •   All Rights reserved   •   E-Mail: murphy@newbeginningsrescue.com
Last Name
First Name
E-Mail Address
Address
City
State
Zip
Home Phone
Work Phone
-
-
Best time to call?
AM
PM
1.  Why do you want to adopt a dog?
2.  What do you think are the most  important responsibilities of owning a dog?
3.  Please list any personal preferences (age, sex, breed, personality)
4.  Have you submitted an application with another organization for a dog at this time?
Yes
No
If yes, where?
5.  Have you ever had an application declined for adoption of an animal from an animal welfare
Yes
No
If yes, explain
7.  If a behavioral problem arises, what steps will you take to work on it?
8.  If you are applying for a puppy/dog that is not housetrained, how will you housetrain the dog?
9.  Does any member of the fmaily have any allergies to animals?
No
Yes
Explain
10. Describe the kinds of personal situations where you might have to return your adopted dog, i.e. job
11. For whom are you adopting the dog?
Myself
Gift
Other Family Member
How many children?
Ages?
Yes
No
Yes
No
Name
Breed
Age
Sex
Spayed or Neutered?
Yes
No
Dog is Primarily
Indoor
Outdoor
What year and How did you acquire this animal?
Pet B
Name
Breed
Age
Sex
Spayed or Neutered?
Yes
No
Dog is Primarily
Indoor
Outdoor
Yes
No
If yes, what will you do with your pet?
Yes
No
Hrs per day?
Days per week?
Yes
No
What type of fence and how high?
Almost Always
Sometimes     
Never
Why do you feel that you can make that kind of commitment at this time?
How long have you lived there?
Yes
No
Please print all information clearly, especially your email address!
12. How many people live in your home?
Yes
No
6.  Are you willing to take the time to housebreak a dog, and do you understand that changing a dog's
environment may cause the dog to have accidents?
loss, children, move, maritial change, etc.
13. Who will be responsible for feeding and caring for your dog?
14. Who will take care of the dog in the absence of the primary caretaker?
15. What reading and other/or steps have you taken to prepare for the new dog?
16. Will you take the dog to obedience training?
17. Will you be willing to obtain an appropriately sized, open-wire crate, if recommended?
18. What kinds of pets have you previously owned?
19. Describe the pets you currently own.
Pet A
20. Do you have plans to move in the near future?
21. Are your current pets up to date on vaccinations and other necessary vet care?
22. What veterinarian would have records (past/present)?  Name, City & State & Phone (w/area code)
23. What veterinarian do you plan to use for this pet? Name, City & State & Phone (w/area code)
24. How much time will this dog spend alone (without human companionship)?
25. Where will this dog stay when home alone?
26. How will you exercise this dog?  How Often?
27. Do you have a fully fenced yard?
28. Type of dwelling where you live? (apt, house, farm with acreage, etc)
29. Do you, yourself own the home?
30. What kind of food will you feed this pet? 
31. How often will you groom/brush your pet?
32. When will you use a leash?          
33. How will you discipline/correct your dog?
34. A dog can live well over 10 years and requires a major commitment of time, money and emotion.
group/animal control facility?
Always
Any other comments that you would like to make that would help us in determining if your home would be a suitable home for one of our dogs?
Not sure if you should adopt?
PLEASE!!!
Watch This Video.
NBSR reserves the right to deny foster to any party for any reason that NBSR deems as suspicious, or contrary to the beliefs and practices of NBSR.
.