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Please scan and email to Dreamscometruerescue@aol.com, or print and mail to Dreams Come True Rescue 945 Willow Brook Rd Plainfield NH 03781

Name:     _____________________                             Date: ________________

 

Address: _____________________          Interested in Dog/Puppy named: ___________________________

 

_____________________________

 

Phone:     _____________________          Email:      ______________________

 

Name Of Vet: _________________

 

Own or Rent:  _________________

 

Place of Employment:

_____________________________

 

Proof of homeownership must be shown re: tax or mortgage statement prior to adoption. If renting proof of pet allowance must be provided from land lord prior to adoption.

 

Please provide a description of prior pets, and disposition.

_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

 

Have you ever surrendered a pet, and if so for what reason?

_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

 

Please list family members and ages living in home.

_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

 

Any allergies to pets known of family members?

_______________________________________________________________________________

 

Are you willing to supply a reference from your Veterinarian?

_______________________________________________________________________________

 

How long would animal be alone in the home?

_______________________________________________________________________________

 

Is yard fenced?

_______________________________________________________________________________

 

Are you willing to have a home-check done?

_______________________________________________________________________________

 

Please list two personal references with contact information:

_______________________________________________________________________________________________________

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