Do you wish to

Name or description of the dog you are applying for:

 Your full name (s)


Town, State & Zip

Phone Cell Text? Yes No


Have you owned a dog before? Yes No If yes, when?

If yes, what happened to your last dog? 

What breeds have you owned?

If you are looking for a guard dog, explain why, and give your definition of what a guard dog is.

Do you have other pets at home?  Please list age, breed & sex.

Are they neutered or spayed?   Yes No

If no, explain why not.

Why do you want a dog?

Do you own your home? Yes    I live in

How long have you lived at your present home?

Do you rent a home? Yes         It is:

How long have you rented at this house? Do you have a lease? Yes No

How long do you intend to rent this home?

Does your landlord give permission for you to have a pet?  Yes No

Do you share your home with a roommate or roommates? Yes No

Do you have a securely fenced yard? Yes No

Is it big enough for a dog to run in? Yes No

If no, how do you intend to exercise your dog?

Do you have a doggy door? Yes  No

Do you have a security door or a screen door? Yes  No                                                                             

Where will your dog be when you aren't there?

How long during the day would your dog be alone at your house?  

If you are applying for a puppy, have you ever had a puppy before?   Yes No

My new dog will sleep

Will you allow your dog to be inside your house, with you?   Yes No

Do you work outside the home?  Yes No 

What do you do for a living?

Are you a Snow Bird?   Yes.

If so, where is home?

Are you military? Yes No

If yes, how often do you expect to be deployed, and what will you do with your dog while you are deployed?


Are you a student? Yes No If yes, what will you do with the dog when you leave here?


Do you have transportation?

Will you be able to transport your dog to the vet, when needed?

Will you be financially able to take care of your pet if it has an emergency illness or accident? 

What would you do if you felt you could no longer keep your pet?

Have you ever had to give away a pet? If so why, and what did you do with it?

How many children do you have at home? What are their ages? 

What experience have they had with animals?

If needed, are you willing to train your kids in the proper handling of pets?

Many relinquished pets have not been trained properly. People discard them, rather than go to the trouble of training them. Are you able and willing to train your dog?   

Would you be upset if a dog had an accident in your home? 

Dogs are a lot like children, and they require almost as much time and effort. They need love & patience & to be a big part of your life. It can take some time for a new dog to settle in. Sometimes the first weeks are rough, for a variety of reasons. We are here to try and help you, should you need advice.

Are you prepared to be patient & not give up?

Are you prepared to make a lifetime commitment to this pet?

Are you  at least 18 years of age? Yes No  If no, we will need parents permission in


Do you understand and agree that should you find yourself unable to keep this animal for any reason, you will immediately email us at azrottis@aol.com, and you will return the animal to Arizona Desert Rotti & Pals Rescue? Yes No

Would you be interested in fostering for Arizona Desert Rotti & Pals?

Would you like to tell us anything else? Comments or concerns?


Thank you for your patience in filling out this form.                                   

Arizona Desert Rotti & Pals will be in contact with you within a day or two.