- Name(s):
______________________________________________________________________
-
Address:______________________________________________________________________
City,
State, Zip_________________________________________________________________
- Phone No. (with area
code) Home: ___________________
Work: _______________________
- Fax No. (with area
code) _______________________
Email: ___________________________
- Optional: Drivers
License No. (with state): ________________ SS.#______________________
- Date of Birth:
_____________________ Marital
Status: ______________________________
- Occupation:
____________________
Spouse’s occupation: ___________________________
Employer’s Name:
_____________________________________________________________
Employer’s
Telephone Number: ___________________________________________________
May we contact your employer? ________ Yes _________No
- Names and relation of
other adults in household: ______________________________________
- Names and ages of children living in
household on a regular basis:
___________________________________________________________________________
- If no children,
planning on children? ________________________________________________
Do you currently own dog(s)? No: _____ Yes: _____ How
many?________ Breeds and Sex?
______________________________________________________________________________
_____________________________________________________________________________
Ages:________________________ spayed/neutered?
_________________________________
Other Information:
______________________________________________________________
Would you be interested in breeding your Rescue Mastiff? No: _____
Yes: _____
Do you currently own any other type of pets? No: _____ Yes: _____ How
many? ______
What kind?
____________________________________________________________________
Are you interested in Male:_____ Female: _____ Either: ______
Age preference: Puppy: _____ Young adult:________ Older dog:
____ Color: _______
Would you be willing to help with transporting your Rescue Mastiff to
your home? No: _______
Yes: _____ Distance or time?
_____________________________________________________
Are ALL family members in agreement about getting a Mastiff? Yes:
_____ No: _____
Explain:
______________________________________________________________________
Residence: Apt/condo: _____ Townhouse: _____ Trailer: _____
Single Family: _____
Farm: _____ Other:
___________________________________________________________
Own: _____ Rent: _____ Rural: _____ Suburban: _____ Urban:
_____
If rent, does Landlord approve of giant dogs? Yes: _____ No:
_____ Landlord’s Name and telephone number:
______________________________________________________________
If rent, please attach written permission from Landlord to have a
Mastiff on the property.
Fenced yard: Yes: _____ No: _____ Type of fence:
__________________ Height: ______
If no fence, how do you plan to exercise your
dog?____________________________________
Where will the dog live? Inside: ___ Outside: ___ Kennel: ___
Other (list): ___________
If the dog will live outside, describe the type of shelter it will have:
_______________________
Will the dog be Fenced: _____ Tied or Chained: __________ Free to
roam: _____________
- Do all adult family
members work outside the home? __________________________________
Approximate hours: _________Would the dog be left alone for 40 or more
hours a week? _____
Where will the dog be kept when it is alone?
_________________________________________
Where will the dog sleep at night?
__________________________________________________
Have you ever owned a giant breed of dog before? No: _____ Yes:
_____
Breed_________________________________________________________________________
What happened to previous dogs: Ran away: _____ Stolen: _____
Sold: _____ Given away: _____
Why?___________________________________________________________
Given up to Rescue or a shelter? If so,
why?__________________________________________
Euthanized? If so,
why?_________________________________________________________
Died? _____ Cause of death? ____________________________________
Age?_______
What did you like the best about your past
dog?______________________________________
What did you like the least about your past
dog?______________________________________
What do you like the best about your current
dog?_____________________________________
What do you like the least about your current
dog?_____________________________________
Why did you decide you wanted a Mastiff?
__________________________________________
Are you familiar with the characteristics and temperament of a
Mastiff?____________________
What do you like about the Mastiff
breed?____________________________________________
What books have you read about the
Mastiff?_________________________________________
Selecting the Right Dog for YouHere
are a series of important questions. Answering all carefully will help
in selecting the right dog for you and your family.
Why do you want a Mastiff ( 1 - 8) 1 = Most Important 8 =
Least Important
Guard Dog: _____ Companion: _____ Watch Dog: _____ Therapy Dog:
_____
Prestige: ______ Child’s Friend:_____ Obedience Prospect: _____
Other: (list) ____________
What
aspect of a dog is most important to you? (1 - 8) 1 = Most Important
8= Least Important
Appearance: _____ Agility: _____ Temperament: _____ Easy
care coat: _____
Quiet companion: _____ Friendly attitude: _____ Size: _____
Other: (list) ______________
If you have other dog(s) how would you describe his/her temperament?
Check all that apply.
Dominate: _____ Mild tempered: _____ Submissive: _____ Aggressive:
_____ Shy: _____ Hyper: _____ Natural leader: _____ Follower:
_____ Friendly: _____ Aloof: _____ Easy going: _____ Laid
back:____ Other (list): ______________________________________
What
type of temperament would best suit your family? And why?
_______________________
______________________________________________________________________________
What is your family’s activity level? Athletic: _____
Moderate:______ Medium: _____ Low:_____ Retired: _____ Other (list):
____________________________________________
What activities do you intend to do with the Mastiff:
_______________________________
_____________________________________________________________________________
Do you subscribe to any dog related publications? No: _____ Yes:
_____ Which ones?
______________________________________________________________________________
Will you take the Mastiff to Obedience Classes? Yes: _____ No:
_____ Why or why not?
______________________________________________________________________________
Are you prepared for the financial responsibility of owning a Mastiff?
Yes: _____ No: _____
How much do you think it will cost per month to feed and care for your
Mastiff? ____________
Name of the primary caregiver of the Mastiff?
_____________________________________
Will all
family members be involved with the care of the Mastiff? Yes: _____
No: _____ Explain:
______________________________________________________________________
Please
list your current veterinarian:
Name:
_____________________________________________________________________
Clinic Name:
________________________________________________________________
Address:
___________________________________________________________________
City, State, Zip:
______________________________________________________________
Phone:
_____________________________________________________________________
Please
list one personal reference:
Name:
_____________________________________________________________________
Address:
___________________________________________________________________
City, State, Zip:
_____________________________________________________________
Phone:
____________________________________________________________________
Please
list one personal reference (non-relative)
Name:
_____________________________________________________________________
Address:
___________________________________________________________________
City, State, Zip:
______________________________________________________________
Phone:
______________________________________________________________________
How did
you learn about Mastiff Rescue?
____________________________________________
______________________________________________________________________________
Do any
family members have allergies to hair, dander, or dust?
___________________________
-
Please list any other information/comments
you feel may help us in placing a Mastiff in your
- home:
________________________________________________________________________
-
______________________________________________________________________________
-
______________________________________________________________________________
-
______________________________________________________________________________
-
______________________________________________________________________________
-
- I certify that the
above information is true and correct and I understand that prior to the
placement of a Mastiff in my home, the above information will be
verified. I also agree to a
personal interview to determine the suitability of my facilities to care
for a Mastiff.
-
-
________________________________________
___________________________________
- Applicant’s Signature
Date
-
-
_______________________________________
___________________________________
- Applicant’s Signature
Date
-
-
- Please return to:
Anne
Healy
Texas State/Regional
Coordinator
Mastiff Rescue
3706 Garrett Blvd.
Deer Park, TX 77536-6655
Phone: (281) 930-0706
Fax: (281) 476-9475
e-mail: MYKANN@aol.com |
Mid
West South Mastiff Rescue
