Rescue Adoption Application

Part 1: Contact Information

Name:

Email:

Address of residence:

Street:
City:
State:
Zip code:

How long have you lived at this address?

Where would you prefer we contact you?

Work
Home

What is that number (area code included) and best time to call?

Mornings
Afternoons
Evenings
Weekend

How regularly do you check your e-mail?

Name of Vet (if applicable):
Phone number of Vet:

Part 2: Home and Lifestyle

Check type of housing:

Own house
Own condo
Rent house
Rent apartment
Other:

Landlord's name and phone
(if renting):

Name:
Phone:

Your neighborhood/property is:

Rural
Suburban
Urban
City
Other

Do you have a yard?

Yes
No

If yes, is the yard securely fenced?

Yes
No

If yes, please describe your fence briefly (material, age, height, etc.)

Do you have an outdoor kennel?

Yes
No

If yes, please describe material, top, base surface:

Do you have a pool?

Yes
No

Number of household members:

Adults: 1 2 3 4 5 6 7 8 9
Age of adult(s):
Children: 0 1 2 3 4 5 6 7 8 9
Age of children:

Are they in accord with owning a Vizsla?

Yes
No
Undecided

What will their relationship be to the Vizsla?

Who will be responsible for the care and exercising of the dog?

Please tell us anything further about your family that you would like to share:

Any known allergies to domestic pets?

Yes No

What changes in your life (new baby, grandchildren, home, job re-location) are you anticipating in the next year?

What changes in your life (new baby, grandchildren, home, job re-location) are you anticipating in the next 5 years?

Describe your typical day on a weekday:

Describe your typical weekend:

Part 3: Current pets

Part 4: Previous Pet History

Part 5: Rescuing a Vizsla

Vizslas are high-energy dogs. How will you see that your Vizsla gets exercise?

Most dogs, especially rescues, need training, retraining or refreshers. What are your thoughts on this?

Sometimes we are called about Vizsla mixes needing homes. Are you interested in being contacted about a Vizsla mix?

Sometimes rescue Vizslas display unacceptable behavior such as fear, aggression, or poor housebreaking. What knowledge and experience can you offer to provide training, understanding and love to your rescued Vizsla?

If we have no Vizslas in Northern California needing homes, would you like us to share your application with other Vizsla rescue groups in the United States?

Yes No

Please describe in detail any interaction you've had with the Vizsla breed, including (but not limited to) other owners you have spoken to, books you have read, Vizslas you have met, etc. Also please give a general description of your knowledge of the breed:

Would you like an opportunity to visit with a Vizsla? Or, have one visit you?

Yes No

If someone referred you to Vizsla Club of Northern California Rescue, please tell us so that we may thank them:

Reason for wanting a Vizsla:

Watchdog
Companion
Hunter
House pet
For children
Companion for other pet
Other (explain):

Information regarding the dog you are interested in:

Male Female Either
Age preference:
Temperament (i.e., playful, quiet, mature, etc.):

What about the Vizsla appeals to you?

We all have our own ideas of how much family time ought to include the dog(s). Where will you keep the Vizsla while you are:

away from home:

on vacation:

running errands:

Where will the Vizsla sleep at night?

Please outline any other expectations or concerns you may have:

Part 6: References

Please provide two personal references whom we may contact. References should know you and your home well, and should be unrelated to you. Please provide names, addresses and phone numbers.