Address (cont):

County:

work phone:

Fax:

Do you have a fenced yard?:

Do you have a swimming pool?

Do you have children that would be exposed to this dog?:

If yes, how many and how old?:

Who will be the primary caregiver for this dog?:

Are there other pets in the household?:

If yes, what type, age, and gender:

Where will this dog be during the day?:

Where will this dog stay at night?:

How many hours will the dog be alone?:

Would you prefer a male or female or no preference?

Approximate age of dog preferred?

Would you be willing to take an older dog?

Would you be willing to take a dog that is not completely housetrained?

Many rescues need a lot of extra time, effort, patience and love to feel comfortable in their new home. Please explain how you would be willing to make such a commitment?

Have you had a scottish terrier in the past or present?

If yes, please tell when and what happened to the dog?

Do you have experience with terriers in general?

Please tell why you would like a scottie as a pet?

Please include any additional information or comments here