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NAME:______________________________________________ ADDRESS: Street___________________________________________
City __________________________ State_____ Zip ________

HOME PHONE: ( )_________________ WORK: ____________ please print email:_______________________DATE: __________

Please answer the following questions and return. If you need more space, write question number and comment(s) on back of page)

( Will your landlord permit you to have a Dobe? (written proof needed) 1. I live in a___house___Apartment___condominium___Mobile home___Other 2. Living in my house is/are (number of) __Adults (count children over 15 as adults) *___Children: Ages: ___ ___ ___ ___ ___ * ___Grandchildren who visit. Ages: ___ ___ ___ ___ *___ Dog(s) Please list sex, spayed or neutered, age, breed. Will small pets be protected from the Doberman?

___________________________________________ ____________________________________________

Cat(s) _____ Indoor_____ Outdoor_____

Other Pets __________ _____________ _________ 3. I work____hours per day. My spouse/partner works ___ hours per day.

4. I have owned a Doberman before __ YES __NO 5.Who wants the dog the most:____Myself ____Spouse/part.____ Children ____ Everyone
6. My reason for wanting a Doberman is (check as many that apply):

___Companion ___Protection___Company for my other dog ___Other.....Explain:

7. Do you have a fenced yard? ____yes ___no. Type of Fencing________ Height_______Has a dog run ____, is it secure?________Dog will have to be chained ____

Do you have a pool? _____yes ___no If yes, are you aware that some Dobes have to be taught to swim, and all dogs should be taught where the steps out of the pool are. ____Invisible Fencing? ___Dog will have to be boundry trained _____Too large to fence. Size of yard/area: ____________Type of latch for gate(s)?___________Locked?Have you checked your yard for dangerous articles and aids in climbing the fence?____ Can children open the gate(s)?________

8. How will you exercise your Doberman? I will exercise my dog by: ____putting it in the yard ____Walking on a leash ____Letting it run at a park, ___Biking with dog ___Jogging with dog.(other- Explain)

9. Will the dog live in the house? ____yes ___no When I leave home it will be kept: ___Loose in house ___Confined in house ___Loose Outside___allowed to roam. (I have a dog house___)
Where will the dog sleep?_____________________

Do you travel frequently? _____yes _____no If yes, what will you do with the do when you travel?__________________________________________________________

Are you aware of any distractions outside or within your yard that could bother the dog? Such as dogs, neighbor's kids, loose dogs, ect. If yes, please explain____________________________________________________ If yes, how will you solve the problem? Please list your previous pets (if any) how long they lived, and what happened to the pet(s). 10. In comparison to other breeds of dogs, Dobermans need:

___More attention ___Same amount of attention ___Less attention

11. I believe a dog of any age will benefit by taking an obedience class ___yes ___no

12. I have trained dogs before and will train this one myself ___yes ___no

13. I am opposed to crates or cages ___yes ___no

14. I have the knowledge to take a "Problem dog". I would take a dog with the following problem: ___Housebreaking ___Chewing ___lacks manners ___needs socialization ___possibly abused.

15. Are you aware of and able to meet the cost involved in owning a dog,such as Veterinary care, vaccinations, feeding, grooming, boarding ect?)____yes ___no

16. Are you willing to take legal responsibility for the dog? ___yes ___no

17. Are you willing to have a home inspection? ___yes ___no

18. The reason I chose a Doberman:
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have you discussed with your family, the pros and cons of owning a Doberman?___yes ___no

Have you asked yourself whether your lifestyle is so busy you might not have the time/energy to properly care for a Doberman? ___yes ___no
Is your lifestyle such that friends, relatives and children, gain admittance to your home/property and car, without your supervision? ___yes ___no
If you have children, are you willing to accept the additional responsibility of a Doberman? ___yes ___no
If you do not have children at this time, are you planning on having children? ___yes ___no ...If yes, would you be able to handle both the Doberman and a new baby? ___yes ___no
Are you willing to teach your child/children to respect and treat the Dobe with kindness? _____yes _____no
Are you willing to accept that the dog may not like all of yours or your children's friends? ____yes ____no
and that the dog and the children should always be supervised? ___yes ___no Is there anyone in your family who does not want the dog? ___yes ____no
Are you willing to provide the dog with a good home for the rest of its life? _____yes ____no
And that these dogs may live as long as 15 years?___yes____no

19. The best traits of a Doberman are:
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20. The worst traits of a Doberman are:
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21. The dog I adopt will be: (Check as many that apply___Male ____Female~~~___Black ___Red ____Blue ____Fawn

22. The ideal age of the dog I adopt would be ____months___years.~~~~~

23. What age range are you looking for? ______The dog I adopt will be no older than ___months ___years

24. I would adopt a dog with natural (uncropped) ears ___yes ___no

25. Are you willing to enroll in an obedience class with your dog? ___yes ___ no
What amount of time and effort do you plan to devote to training your dog?

26. What kind of work or behavior do you expect from this dog?

27. Are you aware that the Doberman is a working/companion dog and it is mandatory that it receives training, exercise, attention and companionship? ____yes ____no
28. What would be your response if the dog makes a mistake?

29. Do you have a veterinarian that you presently use? ____yes ____no. If no, have you ever used a veterinarian for any past pets? ____yes ____no His/her name address phone#,
_________________ _______________________ __________

30. Please list 3 references and their phone numbers:
His/her name State phone #,
________________________ ____________ ____________

32. Anything else you would like us to know about you?
(_____continue on back of page)

. .

DOBE RESCUE OF MICHIGAN
ATT: CHRISTA PFEIFFER
P.O.BOX 930536
WIXOM MI 48393-0536

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