Your Name:

Email: Phone #

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? No Yes

Do you have a fenced yard? No Yes Invisible Fence? No Yes

My dog will primarily be an… Inside dog Outside dog

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

Dogs_______ Sex_______ Age_______ Years had_______

Spayed/Neutered? No Yes

Cats_______ Sex_______ Age_______ Years had_______

Spayed/Neutered? No Yes

If No - Have you had pets in the past?

Dogs? No Yes

Cats? No Yes

Number of adults in your household? Children/Ages?

Does anyone in the family have allergies to pets? No Yes

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

Are you a student? No Yes

If Yes - Do you have roommates?

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

Are you planning on crate training your dog? No Yes

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

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

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