Tarheel Old English Sheepdog Rescue

SPONSORS

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Date of Application
First Name
Last Name
Street Address
City
State
Zip
Home Phone
Work Phone
Cell Phone
Fax
E-mail
Occupation
Hours
Spouse/Partner Name
Spouse/Partner Occupation
Referred by
Veterinarian (include contact)
Do you own or rent your home?	Rent Own
Is it a single family, condo, or apartment	Single Family Condo Apartment
Do you have fencing?	Yes No
What type of fence?
Dimensions of fenced lot and height of fence?
Is the fenced area attached to the house?	Yes No
Does the fenced area have a door leading into the house?	Yes No
Are you willing to comply with TOES fencing/leash policy?	Yes No
Why do you want an Old English Sheepdog?
Have you ever owned a dog before?	Yes No
What kinds of dogs have you owned?
What happened to your last pet?
How long did you have this pet?
If you have other animals, list type, age and sex.
Have you ever lost a dog?	Yes No
Has one of your dogs ever been killed or injured?	Yes No
Please list the ages of children living at home.
List any allergies of home occupants.
Where will the dog be kept during the day?
Where will the dog be kept at night?
How many hours will the dog have to be alone?
Is someone home during the day?	Yes No
Are you willing to take the dog to obedience class?	Yes No
Indicate preference for the dog's gender.	Male Female No Preference
What age range would you prefer?	Under 3 3-5 years Over 5 years No Preference
When are you available for a personal interview?
Any further comments?