Name(s): _________________________________________________________________________________

Home Tel ( ______ ) _______ - ___________ Work Tel ( ______ ) _______ - _____________ e-mail:___________________________

Address: _____________________________________ City:____________________________ State: _____ Zip: _____________

Name/phone of LOCAL relative or friend NOT living with you _________________________________________________

How many adults in the household? _________________________ Children?/Ages: __________________________

Please keep in mind that greyhounds are large dogs and children should never be left unsupervised with them.

Type of housing: Own home ____ Own Condo ____ Rent home ____ Rent Apt. ____ Mobile home ____ Military housing ____

If renting, do you have permission from your landlord? ____ Name/phone: ______________________________

If you move, what will you do with your pets? ________________________________________________________

How long at present address? ___________________ Do you plan on moving in the near future? __________

If you move please advise GREYHOUND CONNECTION of your new address and telephone number.

Do you have a fenced yard? ____ Type of fence ___________________ Height of fence at the lowest point ___________

Who will be responsible for the dog's care? ________________________ Does anyone have allergies to dogs? _____

What pets do you currently have? (Continue on back page if necessary):
Type of animal (if dog, state breed and weight)	Age	Sex	Spayed/Neutered	Where kept	Where does it sleep
______________________________	_______	______	______________	____________	________________
______________________________	_______	______	______________	____________	________________
______________________________	_______	______	______________	____________	________________
______________________________	_______	______	______________	____________	________________

If your pets are dogs, what temperament are they? Friendly ____ Playful ____ Aggressive ___ Shy ____

Name/phone number of your veterinarian ______________________________________________________________

Have you ever brought an animal to a shelter? ______ If yes Explain __________________________________

What is the reason you want to adopt a greyhound? ___________________________________________________________________________

What else do you want it to be?
Watchdog _____ Hunter _____ Companion for children _____ House pet _____ Companion for other dog _____

Sex preferred: M ____ F ____ Age preferred ________
Temperament preferred: Active _____ Easygoing _____ Playful _____ Affectionate _____ Shy _____

Where will the greyhound sleep at night? ___________________________________________

How many hours a day will the dog be left alone? ___________________________________

Where will the greyhound be kept during the day? ___________________________________

How will you keep the dog confined to your property?
In house _____ Kennel _____ Fenced yard _____ Chain _____ Patio _____ Outdoor shelter _____

Do you have a pool? ______ Do you object to an inspection of your property? ____ When can you adopt? ________________________

If you must give up the greyhound, do you agree to return it to GREYHOUND CONNECTION? ____

Where did you hear about us? _______________________________________________________________

Do you have applications outstanding with any other adoption groups? _______

I/WE certify that all the information on this application is true and correct.

Signature: ______________________________________ Date: ________________

Signature: ______________________________________ Date: ________________