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Adoption Form

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DOG INFORMATION

If you know the dog you want to adopt from our dogs for adoption page,  please tell us who you are interested in. 

You may choose more than one. To do so, hold down the "Ctrl" key and choose as many dogs as you like.

      Please choose the sex of the dog:
       

      What are the details you would like for the dog?
       

Please continue filling out the rest of the form

CONTACT INFORMATION

Full Name:

Address:                                                                                                        

City:                                                                  State:                   Zip:
            

Phone #(don't forget area code)
Day:  

Night:   

Email Address:

Drivers license #

PERSONAL INFORMATION


I live in a :


How long at this address?? 

Occupation:

Where? (company name and address)  

How long at current job?

Have you ever been charged with animal or child abuse?

If so, please explain when, and give details:

Do you have a fenced yard?

Approximate size of fenced yard:

Is fence attached to house?

If you do not have a fenced in yard, how will the dog be exercised?
Please explain.

May we visit your home?

Why do you want a doberman?

Have you ever owned a doberman before?

If so, how long ago?

What happened to the dog?

Have you ever given away or sold a dog before?  

If so, why?


Have you ever surrendered a dog to a shelter?

If so, why?

Please describe how may children, their ages, and other people living in your home.

Where will the dog be housed during the day? And night?

What are your feelings about crate use and if you own one.

How long will the dog be alone each day?

How much time a day would be spent playing/ training the dog?

What other animals do you have?  Please list their TYPE, BREED, AGE, SEX, and 
state if they are neutered or spayed.

Where are these animals kept?

What dog food will you feed the dog?  Please be specific.

Would you be willing to take the dog to obedience classes?

How would you handle a destructive dog?

How would you handle digging?

How would you handle chewing?

Are your pets current on vaccinations, rabies and heart worm prevention?

Name and Phone number of your Veterinarian

List other Vererinarian's that you have used in the past:

Tell us a little about your experience with dogs:

Please feel free to share any additional comments or questions.

I AGREE THAT THE DOBERMAN I ADOPT FROM DPR WILL NOT BE USED FOR WORKING PURPOSES AND WILL BE KEPT INDOORS AS A FAMILY PET

I AGREE THAT IF I CANNOT KEEP THE DOBERMAN FOR ANY REASON I WILL RETURN IT TO DPR IMMEDIATELY

I AGREE THAT IF THE DOBERMAN IS RETURNED I FORFEIT ANY ADOPTION FEE AND/OR DONATION GIVEN TO THE RESCUE.

I HAVE READ THIS APPLICATION IN ITS ENTIRETY AND HAVE UNDERSTOOD AND ANSWERED EACH QUESTION TO THE BEST OF MY ABILITY

DPR CANNOT HOLD DOGS INDEFINITELY. A DEPOSIT WILL BE REQUIRED OR DOG WILL BE MADE AVAILABLE FOR THE NEXT ADOPTER. IF DOG IS NOT PICKED UP BY ADOPTER WITHIN FIVE DAYS OF DEPOSIT, ADOPTER FORFEITS DEPOSIT AND ALL CLAIMS TO DOG. 

Thank you so much for filling out this form.  Someone will be contacting you shortly.!


Please press only once, Thanks! :o)

We are currently experiencing problems with the server and this form may not
work properly. The Tripod.com form handlers are experiencing problems.
If you have problems,  please email or call 919-932-7961
We are sorry for any inconvenience...
You can contact our webmaster for
any technical questions.

This page last updated:
02/20/03 07:15:38 PM

  

Bill & Cyndi   Email   [Chapell Hill]
[919] 932-7961

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