Name:

Address:

City:   

State:

Zip Code:

Phone:

Home:

Work:

e-mail address:

Co-applicants:

Your Age:

Spouse's age:

Number of Children: 0 1 2 3 4 5 more than 5

Your children's ages:

Other residents in your home (include relatives living with you, roommates, etc.)

Name:

Age:

Do the other residents of your home also want a Irish Wolfhound? Yes No

Your occupation:

Your employer's Name, Address, and Phone Number:

How long have you worked for this employer?

If less than one year, previous employer, (please give name, address, and phone number):

How long with that employer?

What are your current work hours?:

Are the other members of your household employed outside the home?   Yes No

What are their current work hours?:

What type of car do you drive? (Please specify make and model):

If you drive a pick-up truck, where will your dog ride? (please be specific)

Are you in the military? Yes No

If you are in the military, what do you plan to do with your dog should you be stationed overseas or another post where you could not take you dog? Not In Military Give to family member Take to the pound Leave Let loose in the country Try to sell Call Great Creatures Rescue Other

Long range Family plans (please be as specific as possible:

What is your current residence? Apt/Condo Townhouse Duplex Mobile Home Boat Single Family Farm Other

Do own or rent? Own Rent

If you rent, do you have your landlord's permission to have a dog?  Yes No Haven't asked

How large a dog will your landlord allow?  Up to pounds.

Where will your dog live?  Inside Inside/Outside Outside only

Landlord's name and phone number:

Is your yard fenced?  Yes No

Type of fence (choose as many as you have--for example if you have chain link along three sides and privacy along one side, choose "chain link" and "privacy"):  Chain Link Wire Privacy Other

If you do not have a fence, how will you handle toilet duties?

If you do not have a fence, how will you handle exercise?

Will your Irish Wolfhound be allowed inside your home?  Yes No

Size of your home or apartment:

Size of your fenced area:

How often will you take your dog on a leash walk? Often Occasionally Never

How many hours per day will your Irish Wolfhound be left alone? 

What time of day will your Irish Wolfhound be left alone?

Where will your dog be kept when he or she is alone:

During the day: 

At night: 

Are you familiar with the use of a dog grate to train/confine your dog when you are away?  Yes No

Are you willing to use a crate?  Yes No Not sure

Where will your dog be kept while you are away?  In the house, with run of the house Confined to one area of the house In the garage In a crate Tied up outside Outside in the yard Outside in a "run" or "pen"

Where will your dog be kept while you are at home?

inside with the family in a crate in the garage confined to one area of the house Tied up outside Outside in a "run" or a "pen" Outside in the yard

When is your family usually at home? 

Is there any aspect of your home your dog could affect (such as a white carpet, antiques) that would upset you?  Yes No

Are you willing to move breakable and items that may be spilled out of your Irish Wolfhound's reach?  Yes No

What is your level of activity?  Laid Back Constantly on the go Athletic Physically Handicapped

Do you or anyone in your family have an allergy to dog hair or pet dander?  Yes No

Does anyone in your family have any physical impairment?  (Please specify who and what impairment).

What are your hobbies?

Do you travel?  RV Boat Auto Airplane Other

How often do you go away for an overnight or longer trip? 

When you go away for an overnight or longer trip, what will you do with your Irish Wolfhound?  Take him or her with me Board at a kennel Use a pet setter once or twice a day Ask a neighbor to take care of him or her Use a pet sitter to stay in the home Leave the dog outside in the yard Other

Are you willing to permit a home check by someone representing Great Creatures Rescue?   Yes No

Do you currently have a dog or other dogs?  (Please list and specify the breed, their age, and whether they are spayed or neutered)

Do you have other types of pets?  Yes No

If you have other types of pets, please indicate which you have or are planning to acquire.   Cat Bird(s) Rabbits Horses Goats Reptiles Hamster/Gerbil Pig Cows Other

Are your other pets spayed/neutered?  Yes No

Have you ever owned any dogs in the past if you do not have one now?  Yes No

What happened to your previous dogs? (Please be specific)

Do you have a gender preference?  Male Female Doesn't matter

Do you have a preference for cropped or uncropped ears?  Cropped Uncropped Doesn't matter

Do you have a preference for a particular color?  Fawn Brindle Harlequin Merle Black Blue Mantle Doesn't matter

What age are you interested in?  Puppy only Would like a puppy, but will consider an adult Young adult Adult Senior

Would you consider adopting a Irish Wolfhound mix?  Yes No

Would you consider adopting a special needs dog?  Yes No

What type of special needs dog would you consider?   (Check all that apply)  Dog on daily medication Blind Deaf Missing "body part" (limb, eye)

Have you asked yourself if your life style is so busy that you may not have the time and energy to properly care for your Irish Wolfhound?  Yes No

Have you ever taken an obedience class before?  Yes No

Are you willing to enroll your Irish Wolfhound in an obedience class?  Yes No

Has anyone in your immediate family or who is living with you ever been convicted of or charged with cruelty to animals?  Yes No

Why do you want a Irish Wolfhound?

What dog behavior do you find objectionable?  Digging Barking Chewing Shedding Licking "Doggie smell" Other

If you move, what will you do with your dog?  Take him or her with me Give to somebody else Take him or her to the pound Leave him or her Let loose in the country Try to sell Call Great Creatures Rescue Other

Do you currently have a veterinarian?  Yes No

Approximate date of last vet visit? 

Your veterinarian's name, address, and phone number (if you do not currently have a veterinarian, please use the list one you had).  

If you have been with your current veterinarian less than one year, please provide the name, address, and phone number of your previous veterinarian.  

Other references (please list five persons unrelated to you who are familiar with you and your previous pets--for example, neighbors, pet sitters, consulting veterinarians, obedience instructor)  Please include their name, address, phone number, and relationship to you.