Your Name:

Email:

Are you interested in receiving information about future TARAA events? Yes No

Where do you live? Apartment House Condo/Townhome/Duplex Mobile Home

Do you? Own Rent - Name of rental complex and/or landlord-

Is there a pet deposit required? No Yes - How much? Is it paid? Yes No

Do you have a fenced yard? Yes No

My dog will primarily be an… Inside dog Outside dog

Do you currently have other pets? If Yes - How Many? ____________

Dogs_______ Sex_______ Age_______ Where kept___________ Years had_______

Spayed/Neutered? Yes No

Cats_______ Sex_______ Age_______ Where kept____________ Years had_______

Spayed/Neutered? Yes No

Have you had pets in the past?

Dogs? Yes No Where kept?__________________ Years had?______ Spayed/Neutered? Yes No

Cats? Yes No Where kept?__________________ Years had?______ Spayed/Neutered? Yes No

Number of adults in your household? Children/Ages?

Does anyone in the family have allergies? Yes No

Which family member will have the major responsibility of caring for the dog?

How would you describe your household? Very Busy Busy Moderate Quiet Very Quiet

Are you a student? Yes No

If Yes - What will happen to your dog at the end of the school year?

How many hours a day will the dog normally be left alone?

Where will you keep your pet while you're at work?

Where will you keep your pet at night?

If crate training, how many hours per day will they be crated?

Do you have a vet? No Yes (name of vet/animal hospital) -