Name
Phone (Home)
Phone (Work)
Phone (Fax, Pager, Other)
Fax
Pager
Other
Address
City
State
Zip
E-mail Address
*This field is required so that we may respond
to you.
How Long At This Address?
Who else lives with you?
Employed
Why do you want to own a Lab?
How soon do you hope to adopt?
ASAP
1-2 months
2-3 months
4-6 months
Within the year
Whe the specific Lab is available
List previous dogs:Include their breed and what happened to them?
List current pets:Name, Breed, Age, Gender, Spayed or Neutered and anything that CILRA should know about this pet.
Name, Address, Phone # of current vet.
Is someone home during day?
Yes
No
Where will the Lab be during the day?
Where will the Lab be during the night?
Fenced yard
If No Fence, how will you confine your dog to your property?
Describe your exercise plan for your Lab;
Describe plans for care of your dog while away:
Are you willing to obtain a crate and crate train your dog?
No
Yes
Are you willing to take your dog to an obedience course?
No
Yes
If not, why?
Are you willing to have a CILRA rep visit your home?(By appointment)
No
Yes
What behaviors would cause you to give up your dog?
Describe the type dog that would fit best with your family.
Lab Color Preference
Lab Gender Preference
Lab age range?
No Preference
0-1 year
1-2 years
2-5 years
5+ years
Would you consider a Lab mix?
No
Yes
In most cases, this may simply mean the dog is a bit smaller than a purebred, or has a slight color variation not allowed by purebred standards, but still has the general characteristics and
temperament of a Lab.
How did you hear about CILRA? (Be Specific)
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