Adopt ~ A ~ Setter
IRISH SETTER RESCUE APPLICATION

 

Name  ________________________________________________________________

 

Address_______________________________________________________________

 

______________________________________________________________________     

 

How long have you lived there?_________________________________________    

 

Email address_________________________________________________________

 

With whom are you/spouse employed?____________________________________

 

Occupations?__________________________________________________________

How long have you worked there?_______________________________________

 

Phone (day) _________________ Phone (night) __________________________

 

Members of household and their ages: _________________________________

 

______________________________________________________________________

 

Other pets, their breeds, names and ages: ____________________________

 

______________________________________________________________________

 

Veterinarian's name and phone: _______________________________________

 

______________________________________________________________________

 

Do you own_____ rent _____ your house ____ apartment _____ condo _____

 

Do you have a pool? ______  In the ground or above?___________________

 

If in the ground is it separately fenced?_____________________________

 

Do you have a fenced yard?  __________________________________________

 

If yes, height of fence _________ size of fenced in area______________

 

Type of fence?________________________________________________________

 

If you do not have a fence, how and where will the dog be exercised and

 

Be allowed to eliminate?_______________________________________________

 

Neighborhood type:  city __________ suburb __________ rural __________

 

If you are renting, name and phone of landlord: ______________________

 

______________________________________________________________________

 

Where will the dog live during the day? ______________________________

 

At night? ____________________________________________________________

 

Is an adult family member home during the day?  ______________________

 

If not, give hours dog will be left alone  ___________________________

 

Have you owned a dog before?  _____ If yes, please give details (breed,

 

where did you get it, what happened to it?) __________________________

 

______________________________________________________________________

 

______________________________________________________________________

 

______________________________________________________________________

 

Do you plan to change the name of your new dog?_______________________

 

Have you ever crate-trained a dog? ___________________________________

 

Have you ever taken an obedience course with a dog?  _________________

 

Preferences for adoption: male __ female __ age range ________________

 

Would you consider a special needs dog, for example, one that requires

medication, one that needs obedience training? _______________________

 

What do you know about the Irish Setter breed?________________________

 

Who referred you to us?_______________________________________________

 

Who will be the primary care person for this dog?_____________________

 

What are your plans and goals for this dog?___________________________

 

Briefly tell us why you want an Irish Setter _________________________

 

______________________________________________________________________

 

______________________________________________________________________

I certify that the above information is true and I understand that, prior to the placement of an Irish Setter in my home, the above information may be verified. I also agree to a personal interview with a member
of the Irish Setter Rescue Program, if requested, to determine the suitability of my home to care for an Irish Setter.


Signature ____________________________ Date ______________________

 

Please return to:  Deanna Cuchiaro

W-732-514-6014

Fax-732-514-6038

irishrescue1@aol.com

http://www.irishrescue.org

http://www.irishrescue.petfinder.org