Please provide the following contact information:

Name
Street address
Address (cont.)
City
State/Province
Zip/Postal code
Country
Work Phone
Home Phone
FAX
E-mail

Please indicate your Doberman preferences below:

  male                       
  female                     
  either male or female      
black and rust           
  red and rust               
  blue and rust              
  fawn and rust              
color doesn't matter     
  under 1 year old           
  1-3 years old              
  4-6 years old              
over 6 years old         
  age doesn't matter         
  cropped ears               
  uncropped ears             
ear crop doesn't matter  
  docked tail                
  undocked tail              
  tail style doesn't matter  

What attracted you to the Doberman?

Please select the type of Doberman you are looking for:

watchdog companion
                     hunter        obedience work/competition

For your needs, what are the three characteristics that you find most appealing about the Doberman? Choose three:

  active       shy          
playful      calm       
  independent  intelligent  
loving       dominant   
  aggressive   submissive   
other        

Doberman Assistance, Rescue, and Education, Inc., 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
rent an apartment
live with relatives in a single family home
live with relatives in a townhouse
live with relatives in an apartment
live with relatives in a condo

Do you have access to a fenced area to exercise your new Doberman?

yes
no

If you answered yes to having a fence, please describe the type of fence you have:

If you do not have access to a fence, would you like your Doberman Assistance, Rescue, and Education 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 3-6 6-12 12-18 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, please 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 allergic to animals?

yes
no

If someone in your household does have animal allergies, please explain the type of allergy.

Do you have a veterinarian?

yes
no

If you do have a veterinarian, please provide the name and address of the veterinarian.

If you don't have a veterinarian, would you like Doberman Assistance, Rescue, and Education to recommend one? If you answer "no" and don't already have a vet, please explain your reasons.

Please provide the names and telephone numbers of at least two references that Doberman Assistance, Rescue, and Education may contact (neighbors, trainers, breeders, etc.).

How did you find out about Doberman Assistance, Rescue, and Education? Please provide names if possible.

Would you consider volunteering for Doberman Assistance, Rescue, and Education?

yes
no

If you are interested in volunteering, please indicate your area(s) of volunteer interest.

  fostering                                   
  transportation                              
  telephoning                                 
personal interviews of adoption candidates
  computer assistance                         
  contributing to the newsletter              
  fundraising                                 
other                                     

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