Mike & Sandy Kaser (dba Used Pets)

Pet Adoption Application

Thank you for your interest in our dogs. We would appreciate your answers to following questions so that we can best select the right pet for you. All information is treated as confidential. Submission of this application does not guarantee that you will receive a dog. Applications without addresses and phone numbers will be discarded.

NAME: ________________________________________________ Date:___/___/___

ADDRESS: _____________________________________________________________________

CITY: __________________________________________ STATE: ______ ZIP: ______________

HOME PHONE: (_____) _________________ WORK PHONE: (_____) ____________________

FAX(or Cell Phone: (_____)_________________ E-mail:__________________________________

Where did you hear about Pet Rescue? ________________________________________________

Do you own or rent? ______________________________________________________________

If renting: (House) (Duplex) (Apartment) (Mobil Home)..........Does your lease permit dogs? (Yes) (No)

Landlord: ________________________________________ Phone: (_____) ________________

You are: (Single) (Married) (Divorced)

Age and sex of children in the same home? ___________________________________________

Occupation of Head of household: __________________________________________________

Occupation of Partner: ___________________________________________________________

List others in the home who may have contact with the dog, and their relationship to you:

______________________________________________________________________________

Why are you interested in obtaining one of our pets? ____________________________________

______________________________________________________________________________

What do you like about these pets?

_______________________________________________________________________________

What do you NOT want in the pet that you get?

_______________________________________________________________________________

Your previous and current dogs, cats or other pets:

Name............... Breed.................. Sex.. Age Neuter Current Health or Cause of Death.............

____________ ______________ ___ ____ _____ ______________________________________

____________ ______________ ___ ____ _____ ______________________________________

____________ ______________ ___ ____ _____ ______________________________________

You would like a pet that is: (Male) (Female) (Either).. Prefered age range: Youngest ____ Oldest:____

Can you commit to caring for a pet for its lifetime ? ________________________________________

Where will your dog stay during the day? _______________________________________________

Where will your dog stay during the night? ______________________________________________

Type of fence: _______________________________ Fence height _________________________:

How much time will you spend with your dog on a typical day? ______________________________

What will you do with the dog when you go on vacation? __________________________________

If you have to move, what would you do with the dog? ____________________________________

Have you ever taken a puppy through puppy class? (Yes) (No)

Have you ever taken a dog through obedience class? (Yes) (No)

What books have you read on Pet Care or Pet Training? __________________________________

_____________________________________________________________________________

If obedience classes are recommended for the dog, will you attend? (Yes) (No)

Your current Veterinarian: ____________________________ Phone:(____) __________________

Please add any information, facts or comments, which might aid in picking the right pet for you:

______________________________________________________________________________

MAIL TO: Mike & Sandy Kaser, P.O.Box 176, Covington, OH 45318, Phone (937) 473-5587