Careful. . . 
if you hit the "enter" key, your form will be sent.  To move from box to box, 
either use the "tab" key or mouse click inside the boxes.

Name:

To make multiple selections:
Window & Linux users: hold your CTRL key while selecting
Mac users : hold your command key while selecting

No preference Australian Shepherd Australian Cattle Dog Border Collie Other      No preference Mix Purebred   

If other, state preferred breed:

Energy level:

No preference Calm Mid-level Active

Age:

No preference Don't want a puppy 8 - 16 weeks old 4 - 12 months old 1 - 3 years old 3 - 7 years old 8 years and up

Sex:

No preference Male only Male preferred Female only Female preferred

Size:

No preference Under 20 lb (e.g. Chihuahua, Jack Russell) 20 - 25 lb (e.g. Cocker, Beagle, Corgi) 30 - 50 lb (e.g. average Border Collie) 40 - 70 lb (e.g. average Aus. Shepherd) 60 - 90 lb (e.g. Golden Retriever) over 90 lb (e.g Newfoundland, Great Dane

Flexible, but no smaller than lbs.
no larger than lbs

Coat:

No preference Short only Short preferred Medium only Medium preferred Long only Long preferred

Training:

No preference Willing to do training myself Must have some obedience training Prefer some obedience training Must be house trained Prefer housetrained

Activities you plan for your dog:

Do you plan to take the dog to obedience training? 

  Yes No Undecided   

If not, how do you plan to train the dog? 

What are your reasons for wanting a dog? 

Use 3 words to describe your ideal dog:

Where will the dog spend the day?

Loose in home In fenced yard Tied up outdoors Loose outdoors Basement Garage Crate Kennel run In/out via dogdoor

Describe the area:

How many hours will the dog spend alone?

What will be the dog's sleeping area?

In home Outside Garage Laundry room Basement Utility room

Describe the sleeping area:

The house you live in:

House Condo Apartment Mobile Farm Ranch      Rent Own

How long have you lived there?

If renting: do you have permission from your landlord to keep pets? 

Yes No N/A

Can NBCR&P contact your landlord?

  Yes No N/A

If no, why, not ?

Is your yard fenced? 

N/A Yes No

If yes: fence height at lowest point (in footage)

If you have to move, what will happen to the dog?

If you go on a vacation, what arrangements do you make for the dog?

Pet history:

How many dogs have you owned in the last 5 years?

None, I'm a first time adopter

If you have cats, how many?     Are they familiar with dogs?

How many dogs are living with you now?

Please describe breed, temperament, gender,  altered and age:

Other pets:

Dogs no longer with you:

Be specific, please state amount of time owned, breed/size, reason dog no longer is with you & circumstances:

People in your house:

How many children:     Ages and sex:

Adult males:        Ages:

Adult females:     Ages:

Do the children have experience caring for a dog? What is their attitude towards dogs?

Home atmosphere:

Quiet Mid-level Noisy      Mainly family Average Many visitors      Sedentary Moderate Athletic

Where did you hear of North Bay Canine Rescue & Placement?

Is there a particular dog or dogs on the Web site that you are interest in?

By submitting this form, I acknowledge that I am aware of the expenses involved in owning a pet, such as vet, license fees, vaccines, boarding, toys, flea and heartworm control medication, etc., which can be very high. All of the information I have given above is true and complete to the best of my knowledge.