EmailMe Form - ABERDEEN SCOTTISH TERRIER ONLINE APPLICATION

ABERDEEN SCOTTISH TERRIER RESCUE ADOPTION APPLICATION FORM

TODAY'S DATE (MM/DD/YY)......... *

YOUR NAME................................... *

HOME ADDRESS.............................. *

HOME, WORK, AND CELL TELEPONE NUMBER...... *

YOUR EMAIL ADDRESS....................................... *

Are you willing to take a special needs Scotty?.............

yes

-An elderly Scotty?..................................................... *

yes

-A Scotty mix?........................................................... *

yes

-Two Scotties?........................................................... *

yes

Have you ever owned Scotties before?............ *

Yes

Explain why you want a Scotty............................. *

Do you live in an apartment or home?...................... *

Are there any rules or restrictions on dogs? ............... *

Is your yard currently fenced and secure? ...................... *

yes

Who would have access to the secured yard?.......... *

Do you have a pool or open body of water accessible to the Scotty? *

yes

Number of Adults in household: *

Age of primary Scotty caregiver: *

Are there children in the household and what are their ages: *

Will the Scotty come into contact with children? What ages? *

How many hours per day will the dog be alone? *

Where will the dog stay during the day? *

Where will the dog stay during the night? *

How will the dog be exercised? *

What will be typical vacation arrangements for the dog? *

Statement regarding plan for maintaining the Scotty's health: *

List all the pets you currently own. Include breed, age, sex *

How did you hear about Aberdeen Scottish Terrier Rescue *

Name and address of veterinarian reference: *

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ABERDEEN SCOTTISH TERRIER RESCUE