Primary Owner name: ___________________________________________________________________

Secondary Owner name: _________________________________________________________________

Address: ____________________________________________________________________________

City: ______________________________________ State: __________ Zip: _______________________

Home phone: (_______)_____________ E-mail address: ________________________________________

Secondary E-mail address:________________________________________________________________

Primary Owner Occupation: __________________________ Employer: ____________________________

May we contact you at work: Yes ____ No ____ Business phone: (_____)_________________________

Secondary Owner Occupation: ________________________ Employer: ___________________________

Number of adults in household _________ Number of children in household ______ Number of pets _____

Ages and gender of children: ______________________________________________________________

Type/breed of pets, age & gender: __________________________________________________________

Where and how do your current pets spend their day?___________________________________________

Have you owned dogs or pets previously? Yes ___ No ___ If yes, please give details such as size, breed,

sex, how long you had the dogs/pets and what happened to them._________________________________

____________________________________________________________________________________

What do you consider valid reasons for giving up a pet? (Please check all that apply)

Barking _____ Biting _____ Chewing _____ Destructiveness _____ Digging _____ Fleas _____

Moving _____ House remodeling _____ Expense _____ Having a baby _____

Too rough with children _____ Unable to housebreak _____ Other (please specify)___________________

___________________________________________________________________________________

Type of residence: Single family home ____ Condo/townhouse ____ Mobile home ____ Apartment _____

Other (please specify) ญญญญญญญญญ_________________________________________________________________

Do you own your residence: Yes ____ No _____

If not, do you have your landlord's permission to have a large dog? Yes ____ No ____

If yes, may we contact your landlord for verification? Yes ____ No ____

Landlord name: _______________________________ Landlord Phone #: (_______)_________________

How long have you lived at this residence? ______________

Is your yard fenced? Yes ____ No ____

If yes, please note the approximate size of the fenced area, height and type of fencing: _______________

___________________________________________________________________________________

(Please note: Invisible fencing is *NOT* an acceptable fence.)

If not, would you fence all or part of your yard as a condition to adoption? Yes _____ No _____

If yes, what would be the size of the fenced area, height and type of fencing? _______________________

__________________________________________________________________________________

What is the activity level of your household? Quiet ____ Moderately active ____ Very active _____

During what hours is an adult home during the day? __________________________________________

Approximately how many hours would your greyhound be home alone? ___________________________

Where will your greyhound be during the day or when you are not at home?________________________

Where will your greyhound sleep at night? _________________________________________________

Who will be primarily responsible for the care of your greyhound? _______________________________

Are you willing to modify you schedule to accommodate your greyhound's needs, such as going outdoors

into a fenced area or walking on a leash to perform bodily functions at least 6 times per day? Yes __ No __

On a scale of 1 to 5, with 5 being the highest, rate yourself from

1 - Not very dog experienced to 5 - Extremely dog-knowledgeable: 1 ___ 2 ___ 3 ___ 4 ___ 5 ___

Are you aware of the importance of keeping your greyhound on a leash or in a fenced area at all times?

Yes ______ No ______

Are you willing and able to accept full and immediate responsibility for the ownership of a greyhound,

including all health care costs, necessary burdens, and responsibilities of owning a pet? Yes ___ No ____

Are you aware of local ordinances in your area pertaining to owning or housing of an animal?

(I.E., leash laws, required vaccinations, licenses, etc?) Yes ____ No ____ Not sure ____

Are you familiar with crate training? Yes ___ No ___

Which of the following activities would you or someone in your family likely participate in with your greyhound?

Routine walking ____ Routine jogging/running ____ Automobile travel ____ Obedience training ____

Drag-lure coursing ____ Playmate for children ____ Playmate for other pets ____ Other activities (please

specify)_____________________________________________________________________________

Do you currently have a veterinarian? Yes ____ No ____

May we contact your vet for references? Yes ____ No ____

Veterinarian's Name: ___________________________________ Vet phone # (_____)_______________

Personal reference # 1: Name _______________________________ Phone # (_____)_______________

Best time of day or evening to contact reference ___________________________________________

E-mail (If possible) ญญญญญญญญญญ___________________________________________

Personal reference # 2: Name _______________________________ Phone # (_____)________________

Best time of day or evening to contact reference ___________________________________________