Guardian Home Application

Name *

First Name

Last Name

Date of Birth

MM

DD

YYYY

Street Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

I can receive messages at my phone number

Yes

No

Secondary Phone

(###)

###

####

Spouse's Name

First Name

Last Name

Are you familiar with this breed?

Yes

No

Employer Phone Number

(###)

###

####

Spouse Employer Phone Number

(###)

###

####

Employer Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Spouse Employer Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Do you own your home?

Yes

No

Do you rent your home?

Yes

No

If you rent, do you have any roommates?

Yes

No

Do you have fencing?

Yes

No

Landlord's Phone Number

(###)

###

####

Are all adults that reside at your home in agreement regarding getting a dog?

Yes

No

Do you understand the responsibility of owning a dog?

Yes

No

If you have children, have they had exposure to a dog before?

Yes

No

Are there any other dogs in the home?

Yes

No

Are they current on vaccines?

Yes

No

Are they on heartworm preventative?

Yes

No

Vet's Phone Number

(###)

###

####

Do you have cats or small animals?

Cats

Other Small Animals(s)

Are you willing to attend obedience classes?

Yes

No