siberian husky Prospective owner Application

Name of dog interested in...

Name and points of contact:

Email *

Mobile Number *

Home Number

Home Information

City

State

Zip

County

Do you (select one) *

Dwelling type: *

Do you have a home-owner's association that may have restrictions on pet ownership? *

If you rent, may we contact your landlord? *

Do you have a fenced yard or area for your dog? Please describe: *

Personal Data *

Is anyone in your family allergic to dogs? *

Do you own other cats or dogs? *

If yes, how many other pets? *

List breed, sex and age of each pet you own: *

Are your other pets spayed and/or neutered? *

How many hours on the average day will this dog spend time alone? *

Please describe the last dog that you owned and what happened to it? *

Why are you interested in owning a Siberian Husky? *

What research have you done about Siberian Huskies? *

Are you committed to caring for this dog for its lifetime? *

Where will the dog stay during the day? *

Where will the dog stay at night? *

Are you willing to purchase a crate, if needed? *

I understand a home visit may be conducted prior to my being approved to adopt? *

Veterinarian Data:

Phone Number

Address

City

State

Zip

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