Name Street Address City Select State (if you do not live in one of these states, please do not submit an application to adopt) MD VA DC WV Zipcode County Home Phone Work Phone Email Please indicate your Doberman preferences below - Click ANY that apply: Male Female Any Gender Under 1 Year 1 - 3 Years 4 - 6 Years Over 6 Years Any Age What attracted you to the Doberman? Please select the type of Doberman you are looking for - Select ANY that apply: Watchdog Companion Hunter Obedience Work/Competition For your needs, what are the main characteristics that you find most appealing about the Doberman. Choose at least three: Active Shy Playful Calm Independent Loving Intelligent Dominant Aggressive Submissive Other Doberman Assistance, Rescue & Education (DAR&E) recommends that all Dobermans attend basic obedience training in order to facilitate the owner/pet bonding process (plus it's a lot of fun!). Would a formal training program be something that you, as a new owner, would be interested in? If you answer no, please explain. Choose one of the following choices about where you live: Own a Single Family Home Rent a Single Family Home Own a Townhouse Rent a Townhouse Own a Condo Rent a Condo or Apartment Live with Relatives in a Single Family Home Live with Relatives in a Townhouse Live with Relatives in a Condo or Apartment IF YOU RENT: Please provide the name and phone number of your leasing agent or landlord. We will verify that you are allowed large dogs and that there are no restrictions against having a Doberman. Is your yard fenced (select one and then answer the question below that applies)? Yes No If you answered Yes to having a fence, please describe the type of fence you have (ie. height, fence material type, amount of area fenced, etc.): If you answered No to having a fence, do you have access to a fenced area to exercise your new Doberman? Yes No If you answered yes to this question, please describe the fenced area avialable: If you do not have access to a fenced area, would you like your DAR&E Representative to provide recommendations on the safe confinement of your new Doberman? If you answer No, please provide information about the arrangements for safe confinement you've made: Approximately how many hours will your Doberman be alone each day? 3 or less 4-6 hours 7-8 hours 9-12 13-17 18-24 Are you willing to use a dog crate? Yes No How many people live at your residence? Please provide names, the person's relationship to you, and the person's age: What other animals live in your household? Please include names, type/breeds, gender, spayed/neutered, age, how long owned, and where kept: What other dogs have you owned - indicate which ones (if any) were Dobermans. If they are no longer with you, pelase tell why. If the reason is death, please tell us the age of the dog at the time of death and the cause of death. Does anyone in your household have allergies to animals? Yes No If you answered Yes to this question, please explain the type of allergy: Do you have a veterinarian? Yes No If you answered Yes to this question, please provide the name, address & phone number of your veterinarian: If you answered No to this question, would you like DAR&E to recommend one? If not, please explain your reasons: Please provide the names & telephone number of at least two references that DAR&E may contact. Please do NOT list relatives (or significant other/boyfriend/girlfriend). (Types of references desired: friends, neighbors, coworkers, trainers, breeders, etc.): How did you find out about Doberman Assistance, Rescue & Education? Please provide names if referred by an individual. Please read the following statement: "I understand that owning a dog is a lifelong commitment and that I am willing to take on this commitment if I adopt a dog from Doberman Assistance, Rescue, and Education. I certify that all the information I've provided in this online adoption application is accurate and true." If you accept this statement, please indicate so by selecting the accept button. If you do not agree to comply with the statement, please select the decline statement. Accept Decline PLEASE READ BEFORE SELECTING THE SUBMIT BUTTON! Once you select the Submit button below, your form information will be mailed to the DAR&E Application Coordinator if you have your browser setup to properly email. If you cannot email this form, then please contact the DAR&E Application Coordinator at dareappcoord@yahoo.com to receive a copy of the form via email. This is not a secure or encrypted website, it only as secure as your typical email traffic. Helpful Hint: I had to turn off my computer's firewall in order to make it send the email form.