THE MIDLAND LHASA APSO ASSOCIATION

LHASA APSO RESCUE APPLICATION FORM

NAME (Mr/Mrs/Miss/Ms)-----------------------------------------------

ADDRESS---------------------------------------------------------------

------------------------------------------------------------------------------

Tel No:----------------------------------------------------------------------

Please Complete The Following:

  1. Do you prefer a Dog or Bitch-----------------------------------------------------------------------------

  2. Have you owned a dog before-----------------------------------------------------------------------------

  3. Have you a cat or other pet?--------------------------------------------------------------------------------

  4. Have you a dog at present?----------if yes, what breed and sex----------------------------------------------

  5. Are there children at home?----------if yes, state age and No--------------------------------------------------

  6. Is any member of the household at home for most of the day?---------------State hours when the dog would be left alone if entire household goes out daily---------------

  7. What arrangements would you make for the dog during holidays?-----------------------------------------------

  8. Have you a secure garden or live near a park or suitable exercising area?---------------------------------------

  9. Will the dog live in the house or outside in a kennel?----------------------------------------------------------------

  10. Do you understand that there must be no question of breeding the dog or bitch-------------------------------------

  11. Would you be willing for a representative to call and check on the suitability of your home and garden for one of our dogs?--------------------

  12. How did you hear of the Lhasa rescue?---------------------------------------------------------------------------------------------------------

Signature---------------------------------------------------------------------------------Date---------------------------------------------

PLEASE COMPLETE THIS FORM IF YOU WISH TO BE PLACED ON THE WAITING LIST AND RETURN TO:

Mrs J Scarll

The Turbary, Belton, Nr Doncaster, Yorks,   DN9 1PL

Tel: 01427 875982

UPON ADOPTION OF A RESCUED APSO, A DONATION TO THE MIDLAND LHASA RESCUE WOULD BE APPRECIATED.