Name: 

E-Mail:

Address:

City:        State:     Zip:  

Phone - Home:  Work: 

Occupation & Employer:

Co-Applicant Occupation & Employer:

1.  Why do you want a pet greyhound?


2.  How did you hear about our organization?


3.  Your preferences as to age, sex and/or color:


4.  What other pets do you have?


5.  What pets have you had in the past ten years and what happened to them?


6.  Number of adults in household and hours at home:

7.  Number & age of children in your home:
Please note: GPA/MD's general policy is that we do not place greyhounds into homes with children under 6 years old.

8.  Who will be the primary caretaker of the Greyhound?

9.  Are you willing to spend the time and effort required to properly acclimate
the Greyhound to its new home?

10.  What experience have you had with dog training and what methods where used?

11.  Are you aware that a large dog can cost at least $500.00 per year for basic care? Yes     No

12.  How much do you travel and what dog care arrangements will be made when you're away?

13.  Do you anticipate any major lifestyle changes in your household in the next year (such as new job, schedule change, retirement, moving, new baby?)  Please specify:

14.  Describe the area in which you live (city, suburban, rural):

15.  Dwelling type (single-family, two-family, mobile home, apartment, townhouse/condo):

16.  Do you own your home? Yes    No

17.  If no, do you have written permission from your landlord or does your lease permit a dog over fifty pounds? Yes    No
»Landlord's name & Phone number:

18.  Do you have a completely fenced-in yard? Yes     No

»If yes, what is the size of the complete fenced area?
»Height of fence at lowest point:

19.  Is there a completely fenced-in area nearby where you can exercise the Greyhound once or twice a week? Yes    No
»Describe the area:


20.  Are you aware of the importance and reasons for keeping a Greyhound on a leash or in
a completely fenced area? Please explain:

21.  Are you willing and able to take a Greyhound outside at least four times a day to relieve itself? Yes    No

22.  Are you aware that a Greyhound needs to be kept indoors? Yes    No
»Where will the Greyhound stay during the day?
»At night?

23.  If the Greyhound will have to climb stairs, how many?

24.  Do you promise to keep a sighthound collar bearing GPA / MD IDENTIFICATION on your Greyhound and notify GPA / MD if the Greyhound should become lost or stolen? Yes     No

25.  If for any reason you are unable to keep the Greyhound, do you agree to notify and return it to GPA / MD and not place the Greyhound in a shelter/pound or give him/her to anyone else without written consent from GPA / MD's President? Yes     No

26.  Do you agree to GPA / MD, Inc. volunteer(s) visiting your home, if requested? Yes     No

REFERENCES - (should not be family members) Please include the name and phone number of:

Friend:  

Neighbor  

Current Veterinarian's name, address and phone number:


In whose name are the records listed?  

For which pets?  

If you do not have a current vet, please list the name and phone number of an additional reference:


If you are approved for Greyhound placement, do you agree that you will keep this Greyhound as a pet? Yes     No

Do you accept full responsibility for his/her care, releasing the previous owner as well as GREYHOUND PETS OF AMERICA / MD, Inc. and its representatives from any future liability concerning this Greyhound? Yes     No

Please note: A fee of $225 is required at the time of placement to help defray our expenses.

Applicants must sign this version of the application on the day of adoption.