Home | Current/Planned Litters | Clumber Spaniels | Rottweilers | Cardigan Welsh Corgis | Gone But Not Forgotten | Adoptable Older Dogs | Adoption Application

Locksley Adoption Application

*Full Name
*Address
*City
*State/Province
*Zip Code:
*Country
*Home phone
*Other phone
*Place of Employment:
*Website
*E-Mail
*How did you hear about us?
*What type of house do you have?
*Do you own or rent?	own rent
*How long have you lived in this same residence?
*If renting, will your landlord allow pets?	Yes No
*If renting, please give name, address and telephone number of landlord:
*Do you have a secured:	Fence Kennel Fence
*What are the dimensions of your yard, fenced in area, and/or kennel?
*How tall (high) is your fence, if any?
*What type of fence, if any, do you have?	None Chain Link Privacy Brick Invisible Other
*Where, how and when will your dog be contained when it is outside alone?
*Do you have ample shade from the sun and/or shelter from the elements where the containment area is located?	Yes No
*Are you comfortable with the use of dog crates?	Yes No
*When, how, and where will your dog be contained when it is inside alone?
*Approximately how long will your dog be left home alone each day?
*What arrangements, if any, have you made for your new puppy when you are at work during the day?
*Will your dog be a:	Inside dog Outside dog
*How many adults live in your home?
*Your Marital Status:	Single Married Seperated
*How many children live in your home (include step-children who stay periodically or non-custodial children)
*Their ages
*Does anyone in the household have allergies, health problems or physical difficulties?	No Yes
*If yes, please explain:
*Is everyone in your household agreeable to the addition of a dog to your household?	Yes No
*If no, please explain the circumstances behind the "no" answer:
*Who will be the primary care giver of the new dog?
*Could you please tell us about you and your family's lifestyle, including hobbies and interests
*Are you financially able to care for a dog properly?	Yes No
*How many dogs live with you currently?
*Their ages
*Their breeds
*Are they spayed or neutered? If so, please specify who has been. If not, please explain why not.
*Are your dogs friendly with other dogs?	Yes No
*If you are interested in a Rottweiler from us, do you or have you owned a Rottweiler before?	Yes No
*Where and from whom have you purchased your current or previous dogs?
*Do you own other pets?	Yes No
*How Many?
*If so, please specify what other type of pets you have:
*If you have owned previous pets, please give details as to why you no longer have them, including the cause of death (if applicable):
*Which breed are you interested in?	Rottweiler Clumber Spaniel Cardigan Welsh Corgi
*Do you have a preference in gender?	No Preference Female Male
*Will you wait for the right puppy that best suits you?	No Yes
*Would you consider adopting a rescue?	No Yes
*Tell us how you heard about the breed you are interested in and why it appeals to you:
*Have you read any reference materials about this breed?	No Yes
*What types of activities and interests do you want to share with your pet?	Pet  Conformation Showing  Agility  Carting  Schutzhund  Therapy Dog  Herding  Breeding  Tracking  Obedience  Flyball  Other
*Please note that any of the dogs we place as "pets" (not for breeding or conformation showing) are placed no earlier than 10-12 weeks of age and they are spayed/neutered prior to placement. Is this agreeable to you?	Yes No
*Do you consider yourself a breeder and have you ever bred any litters?	No Yes
*If yes, please explain the number of litters you have produced and what breeds:
*Have you owned or exhibited a dog in any type of sporting events before?	Yes No
*Please Explain:
*Are you affiliated with any dog or breed clubs? If so, Please specify which clubs and for how long.
*Your Veterinarian's name, address, and telephone:
*Please specify the names, addresses, and phone numbers of 2 personal references not related to you:
*Are you willing to travel to pick up your new pet?	Yes No
*Are you willing to sign a written contract?	Yes No
*Is there any additional information you would like to share with us?
*Please type your full name into this box. By doing so, you acknowledge that you are electronically 'signing' this form.
*Date

site by Behind Infinity