Date:

Name: 

Domestic Partner Name:

Address:

City, St.,Zip:

Occupation:

Home Phone:   Cell Phone:  

Work Phone #1:  Work Phone #2:

Email Address:

Why do you want to adopt a greyhound? 

What characteristics would you prefer in a greyhound in terms of sex, size, personality, etc.?

How did you learn about GPA FL/SE?

This section of the questionnaire is designed of aid GPA FL/SE in determining the environment a greyhound would be exposed to.

Number of Adults in the home:

Number of hours the greyhound would be alone at one time:

Number of children in your home:   And their ages?

Are there any family members with special needs, such as wheelchairs? Yes No

Where do you live? House Mobile Home Apartment Condominium

Do you own or rent How many years at present address?

If you rent, what are the rules for pets?

Landlord's Name (if applicable)

Landlord's phone:

Landlord's Address:

Landlord's City, State, ZIP:

Any Homeowner/Condominium Association rules that apply to pet ownership? Yes No

If yes, please explain:

Would you be willing to have a GPA Representative visit your home? Yes No

Would you be willing to crate the dog when it is alone during the adjustment period? Yes No

Do you own or have access to a suitably sized airline kennel, dog cage or crate? Yes No

What resting/sleeping space will be available for the dog?     

What outside space is available for the dog (of appropriate size)?     

Is that space fenced? Yes No   If yes, what type of fence? Height ft.

Are you aware of the importance of keeping a greyhound ON a LEASH when outside in an UNfenced area? Yes No

Do you intend to keep your greyhound IN the house? Yes No

Do you have a swimming pool? Yes No     Are there stairs in your home? Yes No

Are you willing and able to walk or let your greyhound outside to relieve itself from 4 to 6 times daily? Yes No

Occasionally we have dogs for placement that have been injured, a broken bone, dropped muscle, etc.  They are rehabilitated before placement and usually do not have long term effects from injuries.  Would you consider adopting one of these dogs? Yes No

Do you agree to keep a collar "Bearing Identification" on your greyhound at ALL times? Yes No

Do you agree to notify Greyhound Pets of America if, for any reason, you can not keep your greyhound, and further agree NOT to give away or sell the greyhound without the consent of Greyhound Pets of America? Yes No

Are ALL members of the household in TOTAL AGREEMENT about adopting a greyhound? Yes No

Are you aware that the greyhound's racing career is over and can NOT be re-activated? Yes No

This section of the application is designed to give us some idea of your past and present experience in keeping and caring for dogs.

Do you currently own any pets? Yes No   If yes, please list the type of pet, breed, sex and age of each pet:

If you do not currently have any pets, have you previously owned a dog? Yes No

If yes, what breed(s)?

How was the dog obtained?

What became of the dog(s)

Have you ever bred or raised dogs? Yes No

Do you have a veterinarian? Yes No

If yes, please give the name, address and phone # of the Vet:

Please give the name, address and phone number of two references.  One of them may be your Veterinarian.
 

I certify that all of the information given on this adoption application is true and correct.

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