Adoption Application

Doberman Assistance, Rescue and Education, Inc. (DAR&E)

We are currently accepting applications from applicants who’ve owned a dog in their adult life.

DAR&E is dedicated to the care of Dobermans and to your satisfaction with the Doberman you receive from us. Please take a few minutes to fill out this questionnaire (you can also download a copy then mail/email it to the address on the form). Your answers will help us to match your needs with the Doberman in our program. Once we receive your completed questionnaire, we will review it and have a home visitor contact you.

PLEASE NOTE
1. DAR&E does not accept adoption applications for homes with children under the age of 10.
2. Adopters must own the property where the adopted dog will reside. They must be at least 21 years of age and independent (i.e. not living at home with parents, etc.).
3. For applicants with room mates. Please note that DAR&E will only adopt out to those applicants
with one room mate, the room mate has to have been living in the home for a year, and the applicant must own the home.

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Applicant's Name *

First

Last

Address *

Address Line 1

Address Line 2

City

AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

County *

Email *

Day Phone

Evening Phone *

Have you applied to adopt from DAR&E previously? *

• Yes
• No

Have you had a home visit conducted by DAR&E? *

• Yes
• No

If so, what year was it done? *

Adoption Information

Gender Preference *

• Male
• Female
• Doesn't Matter

Age Preference *

• Under 1 year
• 1-3 years
• 4-6 years
• over 6 years
• Doesn't Matter

What attracted you to the Doberman? *

What other breeds have you considered? *

Are you looking for a *

• 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
• independent
• aggressive
• shy
• intelligent
• submissive
• playful
• loving
• calm
• dominant
• other

DAR&E, 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? *

• Yes
• No

If no, please explain *

you References a

Family & Home Information

Now, I need to ask you some questions about you and your family. Please remember that these will be used to help us successfully place each Doberman.....

Do you own a *

• Single Family Home
• Townhome
• Condo

The applicant must own the property that the adopted Doberman will reside.

Do you have a fenced yard to exercise your new Doberman? *

• Yes
• No

If yes, please explain *

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? *

• Yes
• No

What best describes how long your dog will be home alone on a typical day? *RarelyLess that 6 hours8 to 10 hours12 or more hours

Are you willing to use a dog crate? *

• Yes
• No

If your are not willing to use a dog crate please let us know where your current pets are kept while you are gone and where your adopted Doberman will be while you are gone. *

How many people live at the residence?

Please include yourself - note that DAR&E does not place dogs with children under 10 years of age.

Resident Name *

Resident Age *

Resident Relationship *

What other animals live in your household?

If a room mate has a pet of their own please list this pet below and list any farm or other animals that live on the property. DAR&E does not adopt males out to homes with males already in residence.

Animal - Name *

Animal - Type/Breed *

Animal - Gender *

Animal - Age *

Animal - How long owned? *

Animal - Where is it kept? *--- Select Choice ---IndoorsOutdoors

Animal - Spayed/Neutered? *Spayed/Neutered?YesNo

Add Remove

What other dogs have you owned as an adult?

Please do not include family dogs while growing up. Include the year that the dog was last owned and indicate which ones (if any) were Dobermans. If they are no longer with you, please tell us 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 have allergies to animals? *

• Yes
• No

If yes, please explain *

Veterinarian Information

Do you have a veterinarian? *

• Yes
• No

Please also include the veterinarian information for any pets belonging to a room mate? If you have owned a pet within the last five years, even if that pet is deceased, please provide the veterinarian information for the vet that oversaw their care. PLEASE CALL YOUR VET AND GIVE THEM PERMISSION TO TALK TO THE DAR&E VOLUNTEER WHEN THEY CALL FOR A VET REFERENCE. If you have a large animal vet, please provide their name and phone number.

List your veterinarian name, address and phone number. *

If you don't have a veterinarian, would you like DARE to recommend one? *--- Select Choice ---YesNo

References

Please give us the names and telephone numbers of at least two references that we may contact (neighbors, trainers, breeders, etc. Please do not list relatives or girlfriends/boyfriends).

Reference Name *

Reference Phone *

Reference Relationship *

Reference Name *

Reference Phone *

Reference Relationship *

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 DAR&E. I certify that all the information I’ve provided in this questionnaire is accurate and true. *

• I agree

Submit My Application