Please list the name(s) of all the dog(s) you are interested in adopting.
   
Name
Address
City, State, Zip
Home Phone
Cell Phone
Work Phone
Email Address
   
How many family members live at your residence?
List all their names and ages:
Have you ever owned a dog before?
If yes, what happened to your previously owned dog(s)?
Have you ever owned a Siberian Husky before?
Why do you want to own a Siberian Husky?
What traits are you looking for in a Siberian?
(Check all that apply)		   Family Companion
   Playmate for other animals
   Guard or Watch Dog
   Playmate for Children
   Jogging Partner
   Other (Please Explain)
Do you currently own any pets?
If yes, please list all pets you own
Species Breed Sex Age Spayed/Neutered
Do you have a secure kennel or fenced yard?
If yes, please describe
Will someone be home during the day?
What will you do with your adopted dog when you are not home?
   
Veterinarian Information  
Name of Clinic or Veterinarian
Address
City, State, Zip
Phone Number
   

I understand by submitting this application for adoption, I am also giving Siberian Husky Rescue of New Mexico, Inc. the permission to contact any and all persons mentioned in the application, for screening purposes only.

I understand that Siberian Husky Rescue of New Mexico, Inc. concerns rests solely with the welfare of the animals. Siberian Husky Rescue of New Mexico, Inc.’s goal is to place each individual animal with the BEST PERMANENT home. I hereby grant permission to use any and all information obtained in screening for the welfare of the animals. All information completed within this form is true and accurate to the best of my ability.
 


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