Name(s):

Address:

City:   State:  Zip Code:

Home Phone:         () -    

Work Phone:          () -  

Emergency Phone:  () -  

Email Address:

Do you have any children in the home?  Yes No   Age(s):   Under 1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18

Please list any pets you presently own:  

Indoor or Outdoor Indoor Pets Outdoor Pets Indoor & Outdoor Pets   Are they spayed or neutered? Yes No

Have you ever owned a dog before?  Yes No  

If yes, when and what kind?

Do you have a fenced in yard?  Yes No

What kind of fencing?

If you rent, do you have permission to keep a large dog in your residence? Yes No

Name and phone number of landlord:

Name/address/phone of the veterinarian you plan to use or have used in the past:

How long will your hound be alone during the day? Less than 1 hour 1 hour 2 hours 3 hours 4 hours 5 hours 6 hours 7 hours 8 hours 9 hours 10 hours 11 hours 12 hours More than 12 hours

Where will your hound be kept during this time?

Where will you hound sleep at night?

Are you willing to use a crate and/or muzzle to help acclimate your hound? Yes No

Do you have any preferences as to male or female? Male Female No Preference

Do you have any personality preferences?

Will you consider a substitute in any of the preferences if we have difficulty in obtaining your first choice?