Marcosa Havanese
My pets are not material possessions, but wonderful gifts entrusted to me……
Hannah Kolzow
43w741 Willow Creek Ct
Elburn, Illinois60119
630-890-9262
Dog Adoption Application
Caring for an animal is a serious responsibility requiring commitment, morally and financially. We reserve the right to place animals based upon the suitability of the particular circumstance for that animal.
Please answer the following questions as completely as possible. You may write on the back of the application if necessary. If a question does not apply, please write “N/A”.
Date______
Name______Spouse/Sig other/roommate______
Veterinarian(s) name and telephone______
Children, name and ages ______
Address ______
Please indicate type of home (house, townhouse, condo, and apartment) ______
Home number ______Work number ______
Cell or pager number ______E-mail address ______
Do you work outside of the home?______
When do you leave in the morning/ when do you return?______
How many hours will the puppy be left alone? Can you come home for lunch?______
Do you own or rent your home? ______
If you rent, can you provide a rental agreement that allows for dogs? ______
Have all members of the household agreed to adopt a dog? ______
What time frame are you looking for a puppy? ______
Do you currently own a dog(s) or other pets? ______
If you answered yes, what breed, age, and sex is the dog(s) or other pets? ______
______
Are you planning on showing your puppy? Breeding?______
Do you have a color preference?______
Do you have a preference as far as male or female?______
Would you consider the opposite sex, if it was the right dog?______
What do you feed or are you planning to your new puppy?______Have you read the DIET page on my website? Are you willing to feed a holistic diet? Do you have questions or concerns about this?______
Have you owned a dog(s) or other pets in the past? ______
If you answered yes, what happened to the dog(s) or other pets? ______
______
When you leave the home or while you are sleeping, where will the dog be kept (backyard, in a dog house, in the garage, anywhere inside the house, etc.)? ______
Do you a fenced and gated backyard? ______
If you answered yes, what material is the fence (iron, chain link, wood, etc.)? ______
Will you provide consistent veterinary care for the dog, including but not limited to, vaccinations, annual examinations, dental, and emergency care? ______
______
Are you in a financial position to provide veterinary care costing $500.00 or more, if necessary? ______
Where will the dog stay when you travel for business or pleasure? ______
Provide any comments you wish: ______
References:______
I have completed the above information to the best of my ability. I declare all the information is true.
Adopter signature ______Date ______
Please do not buy your puppy from a pet shop or broker as nearly ALL these
puppies come from a Puppy Mill where adults live in cages every minute of their
lives, are treated only as breeding machines, are not tested for any inherited genetic
defects, and neither adults or puppies are properly socialized. Buy only from reputable
breeders who are breeding to improve the health and quality of their dogs and
who care about the welfare of the dog.
REFERENCES
DebbieGrunnah-Island Farm 352-598-6464
Dr Shaun Murphy- Meadowview Vet Clinic 630-232-8868
Elisa Mansfield 847-945-0501
Marcie Funk 815-942-3163