Please try to fill out this application as completely as possible. Thank you for your interest!
Name: _________________________________
Address: ______________________________
_______________________________________
City: ______________ State: ____ Zip Code: ____________
Home Telephone: ______________ Work Telephone: ______________
Email address: __________________
Fax number or other contact information: __________________
Status: Married____ Single____ Living Together____ Living with Parents____
Age(s): ___________ Do you (both) work outside the home? __________
What are your work hours? (list each)
________________________________________________________________
Occupation(s): _______________________________________
Length of Employment (years): _______________
If living with other adults, do they approve of this dog? _________
If living with parents, who will be the actual owner of this dog?_____________
Number of children at home or that visit frequently? _______________
Ages of Children: _________________
Do you rent or own? __________ House, apartment, condo, other? ______________
Landlord's name: ___________________________________
Landlord's phone number: __________________ Does landlord allow pets? ___________
How long at present address (years)? ______________
Are you planning on moving in the next 6 months? __________
If you move, what will you do with your pets? ____________________________________
Do you have a yard? ____________ Approximate size: _____________________
Do you have a fence? ___________ Type of fence: _______________________
Approximate fence height (at lowest point): ___________________________
Have you inspected your fence for holes that your dog may try to crawl out of or dig through? _____________________________
Do you have secure latches? _____________________
Can children open gates? ___________________
Have you checked your yard for poisonous plants or other items your dog may ingest? _________________
Is there anything near the fence that would allow the dog to jump over the fence? ___________________
Have you ever owned a Whippet? _______________ If so, when? ___________________
What happened to the whippet? _________________________________________________
Have you ever taken a pet to a shelter? _______________________________________
If so, why? ___________________________________________________________________
List all pets currently at home. Include small caged pets and barnyard animals:
Type of animal | Age | Sex | Spayed/Neutered | Kept In or Out | How long owned
_______________|_____|_M/F_|_____Yes/No______|_____In/Out_____|_______________
_______________|_____|_M/F_|_____Yes/No______|_____In/Out_____|_______________
_______________|_____|_M/F_|_____Yes/No______|_____In/Out_____|_______________
_______________|_____|_M/F_|_____Yes/No______|_____In/Out_____|_______________
List all dogs owned in the past 10 years:
Breed or Mix | Spayed/Neutered | In or Out | How long owned | What happened to dog?
_____________|_____Yes/No______|___In/Out___|________________|______________________
_____________|_____Yes/No______|___In/Out___|________________|______________________
_____________|_____Yes/No______|___In/Out___|________________|______________________
_____________|_____Yes/No______|___In/Out___|________________|______________________
Will you enroll your Whippet in an obedience class? _______________________________
What is your main reason for wanting a Whippet? ___________________________________
___________________________________________________________________________________
What functions do you expect? (check all that apply)
Watchdog____ Hunter____ Breeder____ House Pet____ Companion____
Companion for other pets____ For the children____ Gift_____
If the dog is a gift, who is it for? _______________________________________
Temperament preferred: (check all that apply)
Very active____ Active____ Easygoing____ Lapdog____ Sedate____
Intelligent____ Playful____ Protective____ Affectionate____ Shy____ Independent____ Other____
I would like my new dog to get along with:
Other dogs____ Cats____ Birds____ Farm Animals____ Young Children____
Do all members of the family favor this type of dog? _______________________
Does any member of the household have pet allergies? _______________________
Sex Preference ___________ Will you consider a dog of the opposite sex? ____________
Age Preference? 1st choice _____________ 2nd choice ______________
The oldest dog I would consider should be no older than ________ years.
Are you financially able to care for this dog should it become seriously ill or require surgery? _______________
What arrangements will you make when you go on vacation? ___________________________
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How many hours a day will the dog be left alone? ___________________________________
Where will the dog stay during the day? ____________________________________________
Where will the dog be kept at night? _______________________________________________
How do you plan to exercise the dog? _______________________________________________
____________________________________________________________________________________
Have you ever crate trained a dog? _______________________
Do you have objections to using a crate for your dog's safety? _____________________
Who is your vet? Please provide name, number, and address as a reference.
Vet's Name: ____________________________________________________________
Vet's Phone Number: ____________________________________________________
Vet's Address: _________________________________________________________
Do you agree to return the dog only to Whippet Rescue, if you find yourself unable to keep it? ___________________
Would you be willing to have a club representative visit your home? _________________
How did you find out about us? ______________________________________________________
Please give 2 personal references:
Name | Phone | Years known | Relationship
_____________|_____________|_____________|_____________
_____________|_____________|_____________|_____________
Below please list any additional information you may wish us to consider in placing a Whippet in your care:
____________________________________________________________________________________
____________________________________________________________________________________
I hereby certify all the above information to be true and accurate to the best of my abilities:
Signature: __________________________________________ Date: __________________
Spouse's Signature (if applicable)
_____________________________________________________ Date: ___________________
Please submit this completed form to:
Guin Borstel