Adoption Application
Stickney Toy Breed Rescue and Retirement Sanctuary
Mary Stickney
5675 S.W. 42nd Road
Cortland, Ne 68331
402-613-4306/mary@stickneys.net

ABOUT YOU
Names of all adults in household:

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What dog are you interested in? *
APPLICANT: Name *
APPLICANT street Address *
APPLICANT City State *
APPLICANT Email *
APPLICANT Phone Number *
Best Time to Call *
Number of persons in your household and their ages: *
Do you Own or  Rent   your home? *
Do live in a house or apartment? *
If you rent, do you have your landlord's permission to keep a dog?     *
Do you have a yard?   *
If yes,   How large is your yard? *
Is your yard fenced? *
yes, how high is the fence? *
Do you have a dog kennel run?     *
If yes, how large is it? *
If yes , do you plan on the dog living 100% of the time in the kennel? *
Where will the dog sleep? *
Do you plan to use a dog crate?     *
If yes how many hours per day will the dog be crated? *
Are there currently animals in your home?     *
List current animals: *
I require that you feed either a home cooked diet , a raw diet or a super premium all human grade kibble. Or a mix of these items.  Proper nutrition will lengthen the life of your dog and you will have fewer Vet bills. I will provide you information on these diets. Are you willing to do this?  Yes     No *
I require that you take your dog to the Vet at least one time per year for  Annual vaccinations.  Are you willing to do this?   *
I require that you give your dog heartworm prevtantives.  Are you willing to do this?   *
Please indicate here any male/female preferences you have for adopting a rescued:   *
Would you be willing to adopt a dog with health problems (non-infectious)?     *
If yes, to what extent would you be willing to help a sick dog? *
List your personal and Veternary Referances here: *
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