Name:
Occupation:
Address:
Employer:
City:
Work Address:
State, Zip:
Select State
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California
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Conneticut
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Delaware
Florida
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Tenessee
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Work City:
Phone:
Work State, Zip:
Select State
Alaska
Alabama
Arkansas
Arizona
California
Colorado
Conneticut
Wash. DC
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Massachusetts
Maine
Maryland
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
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New York
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Ohio
Oklahoma
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Pennsylvania
Rhode Island
South Carolina
South Dakota
Tenessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Cell:
W - Phone:
Email:
How did you hear about Greyhounds as Pets?
Why do you want to own a greyhound?
Do you have any preferences regarding age, sex, or color?
2 Years Old
3 Years Old
4 Years Old
5 Years Old
6 Years Old
MALE
FEMALE
Black
Blue
Brindle
Fawn
Red
White
Black Brindle
Blue Brindle
Fawn Brindle
Red Brindle
White & Black
White & Blue
White & Red
White & Fawn
White & Brindle
What other pets do you own?
What pets have you had in the past?
How many adults live in your home?
1
2
3
4
5
How many children live in your home,
Youngest child's age?
0
1
2
3
4
5
0
6
7
8
9
10
11
12
13
14
15
16
17
18
1
2
3
4
5
How many hours each day are you away from home?
0
1
2
3
4
5
Do you own your home?
YES
NO
If you do not own your home do you have permission to have a dog?
YES
NO
Landlords Name:
Phone:
Do you have a fenced in yard? (This is not a requirement)
YES
NO
Is there a fenced in area nearby where you can exercise your greyhound?
YES
NO
Are you willing and able to take your greyhounds outside 4 times a day, on a leash, if you do not have a fenced in yard so that the greyhound can relieve itself?
YES
NO
Are you aware of the importance of keeping your greyhound in a leash when your greyhound is outside of a fenced in area?
YES
NO
Do you agree to purchase a crate if necessary?
YES
NO
Do you promise to keep a collar, bearing identification, on your greyhound AT ALL TIMES and further promise to notify Greyhounds as Pets immediately should your greyhound ever become lost?
YES
NO
Do you agree to notify Greyhounds as Pets if, for any reason, you find that you cannot keep your greyhound, and further agree that you will not give your greyhounds to ANYONE ELSE without Greyhounds as Pets consent.
YES
NO
Vets Name:
Address:
City:
State, Zip:
Select State
Alaska
Alabama
Arkansas
Arizona
California
Colorado
Conneticut
Wash. DC
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Massachusetts
Maine
Maryland
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tenessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Phone:
Please list below two personal references (Names and Telephone numbers)
Name:
Phone:
Name:
Phone:
I certify that the above information is true and correct.
SIGNATURE:
DATE: