Heart Bandits: Adoption application

	Adoption Application

To adopt an Eskie from Heart Bandits:
Complete this form and click "Send Application"
The information you provide will help us match you with the appropriate Eskie in your area.

All items marked with an asterisk (*) are required.
Your application cannot be processed if those items are omitted.
Tip: The tab key will move from entry to entry.

* Name:
Spouse's Name:
* E-mail Address:
	No E-mail? Check this box

* Home Address:
* City:
* State (Province):	* Zip Code:

* Home Telephone:	( ) - Day Eve.
Work Telephone:	( ) - Ext. Day Eve.

Your Occupation:
Spouse's Occupation:

Others living in your home:
Name: Age:		Female Male
Name: Age:		Female Male
Name: Age:		Female Male
Name: Age:		Female Male

Current number of pets:

Pet 1
Name:
Age:
Sex:
Species:
Breed:
Spay/Neuter:
Vaccinations:

Pet 2
Name:
Age:
Sex:
Species:
Breed:
Spay/Neuter:
Vaccinations:

Pet 3
Name:
Age:
Sex:
Species:
Breed:
Spay/Neuter:
Vaccinations:

Pet 4
Name:
Age:
Sex:
Species:
Breed:
Spay/Neuter:
Vaccinations:

* Veterinarian:	No Vet? Check this box
Vet's Name:
Clinic Name:
City:	Telephone: ( ) -
Additional Vet Info:

General Questions:
1.	Why are you considering an American Eskimo Dog as opposed to other breeds?

2.	Have you ever owned an American Eskimo Dog? Please explain.

3.	What type of dwelling do you live in?
	Do you Own Rent ? If you rent, do you have your landlords permission to keep a dog? Yes No
4.	Do you have a fenced area, yard or kennel? If so, please describe the area.

5.	Where will the Eskie live & sleep? Explain fully?

6.	Where do your current pets live & sleep? Past pets? Explain fully?

7.	How will you exercise your American Eskimo Dog? How often? Explain fully.

8.	When you must transport your Eskie, how will the dog be transported?

9.	How will your Eskie be maintained when you are at work or on vacation?

10.	What is your idea of proper discipline for an American Eskimo Dog?

11.	What is your idea of proper and nutritious food for a dog?

12.	Does everyone in your household want an American Eskimo Dog? Yes No
*13.	Will you agree to attend at least one session of obedience classes with your American Eskimo Dog if needed? Yes No
*14.	Do you understand that if you are ever unwilling or unable to keep a dog received through Heart Bandits, the dog must be returned to Heart Bandits? Yes No
*15.	Please describe the characteristics you would like your American Eskimo Dog to have. (age, sex, size, etc.)

16.	Additional Comments:

"In order to keep a true perspective of one's importance, everyone should have a dog
that will worship him and a cat that will ignore him." ~ Dereke Bruce