First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

County*

Email*

Home Phone*

Cell Phone*

Name of dog you are interested in (these selections are dogs already on the website):
Choose an animal: ADELINE BENJI Bingo Boomer BOOMER (Lab) Brownie BUDDY Chase CHOW BOY CHRISTOPHER DARRIEN Elton (Prev. Walmart) FEMA FERRIS FIDGET FRENCH FRY JEREMY JUNE BUG KAY LAURA CROFT Lisa PRECIOUS SNOWY Stubby TAYLOR TIKI Warren Washington Whitley

2nd choice dog you are interested in:
Choose an animal: ADELINE BENJI Bingo Boomer BOOMER (Lab) Brownie BUDDY Chase CHOW BOY CHRISTOPHER DARRIEN Elton (Prev. Walmart) FEMA FERRIS FIDGET FRENCH FRY JEREMY JUNE BUG KAY LAURA CROFT Lisa PRECIOUS SNOWY Stubby TAYLOR TIKI Warren Washington Whitley

3rd choice dog you are interested in:
Choose an animal: ADELINE BENJI Bingo Boomer BOOMER (Lab) Brownie BUDDY Chase CHOW BOY CHRISTOPHER DARRIEN Elton (Prev. Walmart) FEMA FERRIS FIDGET FRENCH FRY JEREMY JUNE BUG KAY LAURA CROFT Lisa PRECIOUS SNOWY Stubby TAYLOR TIKI Warren Washington Whitley

If the dog I want to foster or adopt is new to the rescue and not yet listed on the website, this is the name of the dog I am interested in.

If you are approved to adopt or foster, your approval is for six months, unless you move and must submit more information. Becoming approved does not guarantee the dog you select will be available at the time of your approval. Please select one of the following choices.

Date of Birth (Ages 25+ preferred but not required):*

Occupation:*

Name/Address of Employer? or Self Employed?*

How long have you been employed there?*

Name of Spouse/Partner/Other Adult Household Member:*

Date of Birth (Spouse):*

Please list the full names of any additional human household members, including frequent visitors, and approximate ages. Include children.*

Choose the option that best describes your work:*
Choose one: From Home 8+ hours a day outside the home Part time (less than 8 hours outside the home) Retired Other

Have you or anyone in your household been convicted of a misdemeanor or felony in the past ten years? If so, please explain. We do a background check. If we find that you have been convicted of a misdemeanor or felony in the past ten years and did not disclose it, you will be automatically denied.*

Have you ever given up a pet? If yes, please explain.*

Why are you interested in adopting a pet at this time?*

If you selected a specific dog(s) of interest, why do you want that particular dog(s)?

How did you hear about Ewenity?*

Please describe your plan for pet care in the event YOU pass away or become injured:*

In what type of home do you live? (Preference will be given to Single Family homes for herding breeds.)*
Choose one: Single Family Duplex Apartment Townhouse Condominium Mobile Home Military Housing

Do you own or rent your home?*

How long have you lived there?*

If you rent, please enter your landlord's name and phone number. If you are regulated by a Homeowners Association, please enter their contact information including name and phone number. *

If you rent or have an Homeowners Association, have you received their approval to own a dog of the breed and size you would like to adopt? Do you have restrictions?*

Is your yard fenced?*
Choose one: No Fence Privacy - wood or plastic Chain Link or Farm Wire Invisible or underground Concrete Wall Other

How tall is your fence?*
Choose one: none 3-4 ft. 5-6 ft. 6-8 ft. underground

Please list all pets in the home now and during the PRIOR THREE YEARS, including name, species, breed, age, sex, and whether spayed/neutered or deceased.*

If you have cats, have you researched how to introduce them to a new dog? What is your plan for doing so? *

Please enter the name, address and phone number of your primary or current Veterinarian where your pets or previous pets are/have been seen for exams and vaccines. If you do not have pets yet, please list the vet you intend to use. If the primary/current vet cannot verify vaccine history, heartworm prevention etc., please list the vet info (Name and phone number) of the vet that can.*

Are you a current client with this vet?

Enter your Veterinarian's Phone Number here (include area code)*

We will contact the vet to verify pets are current on vaccines and preventative care. Please provide names of the animals seen with the vet listed.*

Where do you purchase heartworm prevention if not from the vet?*

Who in the household takes care of the current pets and who will care for the new pet?*

How many hours are your animals alone on work days? Weekends?*

Where will the animal be kept when you are home? (e.g. inside, outside, crated, etc.)*

Where will the dog be while you are away from home? (e.g. crated, free roaming indoors, outside in yard, chained, etc.)*

Where will the animal sleep?*

Are there any times you would chain, tether or otherwise tie your dog outside? Please explain when and why.*

Do you you use regular heartworm prevention for your current dogs and will you use it for your new dog? What brand? (If you do not know what heartworms are, or if you would like more information, please indicate here.)*

What brand of dog food do you plan to feed your dog? (e.g. Crave, Taste of the Wild, American Journey, etc.)*

What will your new dog need to get along with? Check all that apply.

What characteristics are important to you in a new dog? Check all that apply.

Do you have any experience with herding dogs? Explain:*

Describe how you will train your new pet. *

Since herding dogs typically do not do well in a home where they will be bored or under-stimulated, what plans do you have to mentally stimulate and exercise the dog you adopt? (e.g. long walks, frisbee, obedience training, stock work, agility, etc.)*

Preferred Breed?*

Desired age/sex of dog/puppy and preferred energy level?*

For what reason would you return a dog to the rescue? What is your plan to keep this from happening? *

Have you applied with any other rescue?*

Personal Reference Name (should not be a relative):*

Relationship to Reference?*

Known How Long?*

Personal Reference Phone with area code*

Personal Reference Email Address*

Personal Reference Name (should not be a relative):*

Relationship to Reference?*

Known How Long?*

Personal Reference Phone:*

Personal Reference Email Address:*

Anything else you feel we should know about you?

How did you hear about us?

To complete your application, please e-mail current photos of the exterior of your home and yard to ewenityphotos@gmail.com. These photos should include all sides of your fence and/or backyard. BE SURE TO INCLUDE THE NAME ASSOCIATED WITH YOUR APPLICATION IN THE PHOTOS E-MAIL.

Ewenity Farm Herding Dog Haven reserves the right to deny any application. Approval for adoption, foster-to-adopt, or foster does not guarantee you will get the dog you are applying for. There may be multiple applications for the dog, the dog may have been adopted by the time your application is approved, or the dog may not be a good fit for your family situation, e.g., the dog may not be good with children or other dogs, not handle houses with stairs, or one of many other situations. We want each dog to go to a home best suited to that particular dog.

I certify that the information entered on this application is true. My entered name and date of application shall stand for my signature. *