Rescue Adoption Consideration Online Form

The PBGV Club of America Cares!

PBGVCA Rescue Adoption Consideration Application

To be considered, you must complete ALL information. Incomplete forms submitted will not receive a response. Please provide complete contact information and answer ALL 9 questions and recheck your email address entry. If viewing on small screen, scroll using bars OR fingers.



:
Last Name:
:
Street:
City:
State: Zip:
Phone (including Area Code):

Please tell us about your living situation:

1) How many people are in your household? Enter #:
2) What are their ages? Enter #:
3) Do you (and/or your spouse) work?
3a) If so, how many hours per week? Enter # of Hours:
4) What kind of residence do you have (i.e., apartment, house, own or rent)
Enter Type:
4a) Do you have a yard?

4b) Is it fenced?

4c) What type of fencing is it? Type:
5) Do you have other pets?

5a) If yes, what kind and how many? (Enter kind followed by #)
6. Do you have a veterinarian?

6a) If yes, please provide his/her name, address and phone:
Name/Address/Phone:

Please tell us about your experience with dogs:

7) Are you a first time owner?

7a) If no, what breeds have you owned? Enter Breeds:

9) Are you familiar with PBGVs?


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