Glen of Imaal Terrier Rescue
Dog Adoption Application (Email Version)
To Submit by E-mail
Copy this entire page (starting below these instructions) by dragging your cursor over it to highlight the text, then select "Copy" from the Edit Menu at the top of the page,
Then click on this email address to open a new email:
Then Click in the body area of the new email, and select "Paste" from the Edit menu to paste the form into the new email . Then fill in all requested information
Name of Applicant(s)
Enter Your Address: Street
City, State, and Zip Code
Enter your home phone number
Enter your work phone number
Enter your email address
Where did you hear about Glen of Imaal Terrier Rescue?
Please answer each question in detail. This helps us match you up with the right dog!
1. Why are you interested in this breed of dog? Are you looking for a male or female?
2. AGE of dog desired?
3. WHEN do you want to adopt?
4. When was the LAST TIME you had a dog?
a. What kind of dog did you have?
b. Was s/he spayed or neutered? If not, Why Not?
d. Where did you get the dog?
e. What happened to the dog?
5. About Your Home:
a. What is your type of dwelling: (House, Townhouse or Condo, Apartment)
b. Do you: Own or Rent?
c. RENTERS: do you have written permission to have a dog of your choice live with you?
d. Do you have a: Fenced Yard, Dog Run, or Neither?
6. How many people in your household? If any children, what are their ages?
7. This dog is desired for an: Individual, Couple, Family. Who will ultimately be responsible for the dog?
8. Describe any other pets in the household.
9. How much will the dog be alone? Describe a Typical Day:
10. Where will your dog sleep at night?
11. HOW, and how OFTEN, do you plan to exercise your dog? (e.g., dog parks, hiking trails, neighborhood walks, etc.)
12. HOW do you plan to Obedience Train the dog?
13. The name and phone number of your vet.
14. If you travel do you have a friend or relative willing to take care of the dog and their name and phone number. 15. If you work do you have someone to let the dog out to relieve itself.
Thank You for filling out this form we will contact you with our desiscion.
DONATIONS ARE APPRECIATED.