puppy Application

NameAddress

City

State

ZIP

Daytime Phone

Evening Phone

Best time to callEmail AddressOccupation

How long at present address?

Do you own or rent?

Note: Renters must send documentation that dog's are allowed to live in this dwelling.

Own

Rent

home life

Where will the pet be kept during the day?Where will the pet be kept at night?Where will the pet be kept when no one is at home?Where will the pet be kept when you are on vacation?How long will pet be left alone each day?

Exercise and elimination for the pet will be:

household composition

Number of Adults

Number of Children

Ages

veterinarian

Veterinarian name

Veterinarian phone number

Veterinarian email (if available)

References

Please list two other references we may contact regarding this adoption

Reference 1

Name

Relationship

Phone

Best time to call

Reference 2

Name

Relationship

Phone

Best time to call

Other pets

Please list all the pets you own or have owned in the last five years. Please list the type, age, gender, whether it's spayed/neutered and where the pet is now.

Dog Preferences

What type of dog are you looking for?

Gender

Male

Female

Desired Age

Would you consider a dog over 3 years old?

Yes

Are looks or size important to you?

Yes

If yes, please explain

Return

Do you agree to return this dog to Lyn-D-Ann's Bostons if you are unable to keep it for any reason?

Yes

LYN-D-ANN'S BOSTONS RESERVES THE RIGHT TO REFUSE ANY APPLICATION

I certify that all the information on this application is true and complete. I understand that if I am chosen as an adoptive home, I will comply with the following conditions of adoption.

Owner shall provide adequate veterinary care.
Owner agrees to notify Lyn-D-Ann's Bostons of any address or telephone change.
Owner agrees to notify Lyn-D-Ann's Bostons should dog be lost, stolen, or dies.
Owner shall return dog if under any circumstances dog can no longer be cared for.
Owner agrees to not sell, give or move this dog from the above listed address, and will not transfer dog to anyone except Lyn-D-Ann's Bostons from which it came.
Owner represents that no member of the household has ever been charged with cruelty to animals.

Signature of Applicant

Date

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