United Russell Terrier Club
Paws For Thought Rescue Online Application
1. First and Last Name:
2. Home address:
8. Email Address:.
33. Refered by:
34. Phone number:
23. Veterinarian:
24. Vet's Phone number:
9. Type of dwelling:
10. Is your yard fenced?
11. Type, height, width of fencing:
25. Why do you want a Jack Russell Terrier?
16. Do you have any other dogs in your home now?
17. If yes, how many?
19. If yes to either of these questions, what breed, age and sex?
14. If married, is your spouse in agreement with adopting a rescue dog?
12.  Do you have any children?
13. Ages of children:
15. Does anyone in your household have any allergies to dogs that you are aware of?
26. Approximately, how many hours per day will the dog be left alone?
27. Where are you planning on keeping the dog when you are not home?
31. Do you prefer:
32. Age preference?
29. Have you ever obedience trained a dog?
30. Are you willing to have a member of the Rescue visit your home prior to &/or after adoption?
18. Are they spayed or neutered?
21. Do you have any other pets?
22. If yes, what type?
Personal InformationPersonal Information
Personal InformationPersonal InformationPersonal Information
Personal InformationPersonal Information
Other PetsOther Pets
Other PetsOther PetsOther Pets
Other PetsOther Pets
3. City:
4. State:
5. Zip:.
6. Home phone:
7. Message or work phone (if applicable):
Rescue Dog InformationRescue Dog Information
Rescue Dog InformationRescue Dog InformationRescue Dog Information
Rescue Dog InformationRescue Dog Information
Personal Information
Other Pets
Rescue Dog Information
20. If no to #16, Have you ever owned a dog before? If yes briefly explain what happened to them.
28. Where would the dog sleep at night?