Limbo Chihuahuas- Application
First Name
Last Nme
Email Address
Address and City
State
Zip Code
Home Phone
Work Phone
Cell Phone
Best time to call
Are you over the age of 21, lving independently, and self supporting?
If you said no, for the previous question, please explain
Click to enter text
How long have you been employed at your current place of employement?
Why do you want to adopt a dog?
What are the most important respondibilites of owning a dog?
Does every member of your household want a dog?
Done anyone in your household have allergies?
Have you had pets before?
Describe your previous pets (type,age,sex, spayed/neutered?)
What is your current profession?
How long have you been employed at your current place of employent?
What are the most important responsibilities of owing a dog?
Does everyone in your household want a dog?
Does anyone in your household have allergies?
Describe your previous pets, (tyoe, age, ses, spayed/neutered?)
Why are these pets no longer with you?
Describe your current pets (tyope, age, sex, etc.)
Are all current pets psayed or neurtered?
Are all current pets up to date on vaccinations?
Are all current pets on a monthly heartworm preventative?
Please provide the name, address, and phone numner of your previous and current pets veterinarian(s)
What name are these records listed under?
***Please contact your vet and give permission for them to release your vet records***
Are there any other pets in the home that do not belong to you?
If you answered yes, , please provide the name, address, and phone number of those pets veterinarina(s).
Do you have children under the age of 18? If so, what are their ages?
Please list other residents in your household and their relationship to you.
How long have you lived at your current address?
In which type of home do you live?
If you picked "other", please explain
Do you own or rent?
If you rent, please provide the name, address and phone number of your landlord
Do you have a fenced in yard?
If yes, please describe your fence (size, type, etc.)
If you do ot have a fence, how do you plan to keep your pet at home?
Where will the dog stay during the day?
How much time will the pet spend outside?
Where will the pet sleep?
How frequently will the adults be done away from home on business or vacations? Where wo;; the pet stay at these times?
Please describe your feeding plan - type of food, schedule, etc:
Describe your housetraining routine:
Will someone be home during the day?
If no,, how long will the pet be left unattended?
What provisions can be made if the pet needs to use the bathroom while left alone?
Please let us know any age preferences you have in adopting a dog:
Please list any size preferences you have in adopting a dog:
Are you willing to accept a dog with special needs?
Please list any gender preferences you have in adopting a dog:
Please lsit any other specific information that may help us find a dog for you:
If you are intrested in any particular dog(s) on our website, which one(s)?
Please provide the name, address and phone number of at least two persosl non-family references:
I understand that a volunteer wills chedule a home visit with my family prior to final approval of adoption. Your typed name below is your signature.
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