Adoption Application

First Name:
Last Name:
Spouse Name:
Address:
City:
State:              select state Alabama Alaska Arizona Arkansas California Canada Colorado Connecticut Delaware District of Columbia Florida Georgia Idaho Illnois Indiana Iowa Kansas Kentucky Louisiana Maine Massachusetts Maryland Michigan Minnesota Mississippi Missioui Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Zip Code:
Previous Address: (complete) If less than 5 years at this address please give previous address below:
Home Phone:
Work Phone:
Occupation:
Spouse Occupation:
E-mail:
What other dogs have you owned in the last 3 years?
Breed	Name	Sex	Alive	Deceased	Age	Spayed/ Neutered
		Male Female				YesNo
		Male Female				YesNo
		Male Female				YesNo
		Male Female				YesNo
Are your pets up to date on all shots?					Yes   No
Are your pets on heartworm preventative?					Yes   No
Do you have other pets?   Please list them
I would like to adopt a Saint for:   Please select Protection Breeding Purposes The Kids A Companion A Gift Guard Dog Obedience Work Other (CTRL click to select more than one)
Other:  (Please explain below):
Please indicate the following about your household:
# of adults:					0 1 2 3 4 5 5+
# of children:					0 1 2 3 4 5 5+
Ages of children:
Which members of your family will feed/care for the Saint?
Does anyone in your home have an allergy to dogs?
This Saint would be alone for hours per day?
I live in a:					please select House Apartment Condo Mobile Home
I/We:					Rent Own
If rent List landlord's
Name:
Address:
Phone #:
If you have a fenced yard, please describe it:
Height of fence:
Type:
Size of fenced area:
During the day, the Saint would be in the:					Select House Yard Garage Kennel Other
Please specify other:
During the night, the Saint would sleep in the:					Select House Yard Garage Kennel Other
Please specify other:
Are you willing to have a home check before adoption?					Yes   No
Are you willing to housebreak the dog?					Yes   No
Are you aware that the vet bills for routine care of a Saint may cost between $100 and $500 or More per year?					Yes   No
The following is required if you have pets Name, address and phone number of current or last veterinarian:
Vets Name:
Vets Address:
Vets City:
State:					select state Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Idaho Illnois Indiana Iowa Kansas Kentucky Louisiana Maine Massachusetts Maryland Michigan Minnesota Mississippi Missioui Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Zip :
Vets Phone:
When you go away for a few days, who will care for the dog?
Have you ever obedience trained a dog?					Yes   No
Explain what training methods and collars you prefer:
Do you realize that Saints shed profusely (especially during the summer months), often drool or slobber, and are prone to hip problems?					Yes   No
Are you aware that when you adopt a Saint, you are taking on the responsibility for its lifetime, which may be up to 14 years?					Yes    No
What specifics are you looking for in a Saint?  (If you are interested in adopting a particular dog, please specify,  and give your reason(s) for your choice):
Have you owned a Saint Bernard before?					Yes   No
What happened to the dog?
How or where have you learned about this breed?
Tell us what you're looking for:
Coat length: select Long Short		Sex: select Male Female			Age: select Less than 1 Year 1 to 3 Years 3 to 5 Years Older Dog (CTRL click to select more than one)
If you have chosen a particular dog, would you be willing to take another if your chosen dog has a medical or other problem that would prohibit its adoption at this time?					Yes No
Are you aware that Saint Bernard Rescue Foundation, INC. requests an adoption fee for each adoption, to help cover expenses incurred in readying dogs for adoption?					Yes  No
Are you prepared to pay this fee?					Yes  No
Tell us about your family life:
Personal References:
Name:		Phone:
Name:		Phone: