| First Name: |
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| Last Name: |
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| Address 1: |
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| City: |
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| State/Province: |
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| Zip Code: |
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| Email Address: |
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| Home Phone: |
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| Business Phone: |
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| Dog #1 - Breed: |
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| Dog #1 - Age: |
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Dog #1 - Sex: |
Male Female
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Dog #1 - Altered: |
Yes No
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Dog #1 - Still Living: |
Yes No
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| Dog #2 - Breed: |
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| Dog #2 - Age: |
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Dog #2 - Sex: |
Male Female
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Dog #2 - Altered: |
Yes No
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Dog #2 - Still Living: |
Yes No
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| Dog #3 - Breed: |
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| Dog #3 - Age: |
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Dog #3 - Sex: |
Male Female
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Dog #3 - Altered: |
Yes No
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Still Living?: |
Yes No
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| Dog #4 - Breed: |
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| Dog #4 - Age: |
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Dog #4 - Sex: |
Male Female
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Dog #4 - Altered: |
Yes No
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Dog #4 - Still Living?: |
Yes No
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Are all of the above dogs that are living still in your home?: |
Yes No
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Are your pets up to date on all vaccinations?: |
Yes No
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1. I would like to adopt a Saint for: (Check all that apply): |
Protection
Breeding Purposes
Kids
Companion
Gift
Guard Dog
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| 2. Number of Adults in Home: |
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| Number of Children in Home: |
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| Ages of Children in Home: |
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| 3. Which members of your family will feed/care for the Saint?: |
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4. Does anyone in your home have an allergy to dogs?: |
Yes No
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| 5. How many hours a day will the dog be alone: |
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6. I live in:: |
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I: |
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7. Fence Height: |
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| 8. Fence Type: |
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| 9. During the day, the Saint would be in the (e.g.. house, yard, garage) : |
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| 10. During the night the Saint will sleep:: |
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11. Are you willing to have a home check before adoption?: |
Yes No
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12. Are you aware that the vet bills for routine care of a Saint may cost between $100 and $500 or More per year?: |
Yes No
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| 13. Name, address and phone number of current or last veterinarian: : |
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14. Do you realize that Saints shed profusely (especially during the summer months), often drool or slobber, and can be prone to hip problems?: |
Yes No
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15. Are you aware that when you adopt a Saint, you are taking on the responsibility for its lifetime, which may be up to 14 years?: |
Yes No
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16. Have you owned a Saint Bernard before?: |
Yes No
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| If yes, what happened to the Saint?: |
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Coat Length Preferred: |
Rough (Long Hair)
Smooth (Short Hair)
No Preference
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Sex Preferred: |
Male
Female
No Preference
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18. Are you aware that we request an adoption fee for each adoption, to help cover expenses incurred in readying dogs for adoption? : |
Yes No
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19. Are you willing to pay? : |
Yes No
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20. Are you willing to pick a dog up directly from a shelter?: |
Yes No
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| Comments: |
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