| Applicant's Name: |
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| Spouse: |
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| Home Address: |
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| City: |
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| State: |
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| Zip: |
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| Home
Telephone: |
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| Work Telephone: |
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| Fax Number: |
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| Email
Address: |
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ABOUT
TIBETAN MASTIFF RESCUE,
INC. FOSTER / ADOPTION
Fostering a Tibetan Mastiff means that you are willing to provide a TEMPORARY home for a TM in need. A foster home may request becoming a permanent adoption home. |
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| Are you willing to foster a TM until a permanent
home can be found? |
yes
no |
| Are you willing to adopt a TM as
a welcome and permanent member of your family? |
yes
no |
| If you are experienced enough with this breed to confidently identify a TM, are you willing to travel to a human society or animal shelter (without reimbursement for your travel expenses) to investigate a report that a TM is being held for adoption in such a facility? |
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| If so, to what states (or within what states) are you willing to travel to make such an investigation? |
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ABOUT
YOUR FAMILY/HOUSEHOLD |
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If
you are married or share your home with another adult,
does your spouse or partner
support adding a TM to
your home? Please
include their initials
affirming so here. |
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| Do you work outside the home? |
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| Your Occupation? |
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| Your work hours? |
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| Does your spouse or partner work outside the home? |
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| Spouse Occupation? |
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| Spouse work hours? |
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| Do you have children? |
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| How many? |
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| Do they all live with you? |
yes
no |
| Please list children's names and ages. |
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| Do others live with you that will have contact with this TM? |
yes
no |
| Who? |
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| Other Comments: |
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ABOUT
YOUR HOUSE, YARD AND
NEIGHBORHOOD |
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| Do you own your home? Or rent? |
own
rent |
| How long have
your lived at this address? |
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| If rental, does the lease allow pets? |
yes
no
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| Your landlord's name/phone. |
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| Is it a single-family home?
Condo? Mobile home? Apartment? |
Single Family Home
Condo
Mobile Home
Apartment
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| Is the yard fenced? |
yes
no |
| Invisible
fencing or traditional fencing? |
invisible
traditional |
| How high is the fence? Is the fence
wood, chain link, etc. |
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| What size is your fenced yard? |
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| Do you live in a rural area?
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yes
no |
| How close is your home to a busy
road? |
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| Do you have a pool on your property?
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yes
no |
| Is the pool independently fenced
from the rest of your yard? |
yes
no
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| Does your town have a leash law? |
yes
no |
| Does your town have a limit on the
number of dogs per household? |
yes
no |
| Other
Comments: |
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ABOUT PRIOR PET OWNERSHIP |
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| Have
you ever met a TM? |
yes
no |
| If yes, whose? |
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| Do
you currently own a TM? |
yes
no |
| If yes, dog's full name: |
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| Do
you currently own any other dog(s)? |
yes
no |
| Please
describe your current dogs by breed, gender (neuter or spayed?)
and age: |
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| Have
you owned a TM in the past? |
yes
no |
| If yes, dog(s) full name(s): |
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| Have
you owned any dog in the past? |
yes
no |
| Please
described the cause of death for dogs you've owned in the past: |
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| Do you own any cats? |
yes
no |
| How many? |
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| Are
they declawed? |
yes
no |
| Are your cats socialized to dogs? |
yes
no |
| Do
you have any other pets
in your home (guinea
pigs, birds, reptiles, ferrets, etc.)? Please
describe animal and its
containment. |
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| Do
you have any livestock
on your property? |
yes
no |
| Please
describe animal and its containment. |
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ABOUT
RESPONSIBILITY FOR
AN
ADOPTED / RESCUED
TIBETAN MASTIFF |
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| Who
will be primarily responsible for this TM? |
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| Where
will this TM sleep? |
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| Where
will this TM spend time during the day? |
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| How
will this TM be exercised? |
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| Please
note - you MUST provide us
with a vet referral. |
| Veterinarian
name? |
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| Vet phone number? |
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| Veterinarian
address? |
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| Have
you ever obedience trained
a dog? |
yes
no |
| Are
you willing to work on obedience with your TM? |
yes
no
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| Do
you have access to training classes near your home? |
yes
no
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| If
it is determined that the TM is in need of long term medial
care, are you willing to commit the resources to do so? |
yes
no |
| Identify
the problems that you feel you are capable of handling in
a potential rescue dog |
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| Why
do you want to rescue a TM (companion, guard dog, gift, to
breed, personal protection, playmate for current dot, for child,
replace previous dog, other)? |
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| Have you contacted any TM breeders? |
yes
no |
| If so, whom? |
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| Have you ever surrendered a dog to
a shelter or rescue organization? |
yes
no |
| If so, why? |
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| If a TM were placed with you and
you could not keep the
dog, what would you do
with it? |
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| How did you hear of Tibetan Mastiff
Rescue, Inc? |
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| Are
you interested in a particular dog on our web site? |
yes
no |
| If so,
which one? |
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ACKNOWLEDGEMENT |
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| I
acknowledge that all of the information provided in this Application
is true and accurate |
| Date: |
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| Applicant's
Initials |
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| Applicant's
Spouse/Partner's Initials |
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