Name
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First Name
Last Name
Address
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Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Email
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Phone
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Resident Time
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How Long have you lived at your current address:
Please list every person, their relationship to you and their age who currently resides at your residence including yourself.
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Does anyone in your household have any known allergies to animals? If Yes, please explain.
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Who will be responsible for the dog's care and training?
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Do you have a second home? If yes, give address and share how often you are there.
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Preferences:
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Please check any preferences. (Note that the age and pedigree of dogs rescued from animal shelters cannot be verified.)
Other Preferences:
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Are you will to consider a dog...
How long are you willing to wait for a Kerry Blue Terrier?
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Please explain your needs.
Why a Kerry?
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How did you first learn about the Kerry Blue Terrier breed? What attracted you to the Kerry Blue Terrier?
Your Dog Choice
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How would you describe the ideal dog for you and your family? (Be Specific) and have you considered any other breeds? Have you discussed the pros and cons of owning a Kerry Blue, or do you have any concerns about the breed?
More about the Kerry Choice
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Are you familiar with the temperament and characteristics of terriers in general and Kerries in particular? Explain and share with any experience you have had with the Kerry Blue Terrier breed.
Have you owned a Kerry?
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If you have owned a Kerry Blue, what date did you acquire it, who was the owner or breeder, where did the dog come from and what type of temperament did it have?
IF you did not ever own a Kerry Blue Terrier, have you ever met one? Describe please.
Pet Ownership: Why do you want a dog?
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Please answer these questions below:
1. Why do you want a dog? Do you have any reservations about dog ownership, the commitment, responsibilities, the work and resources required? Describe please.
2. Have you ever owned a dog before?
3. If not, have you ever lived in a household with a dog? How long ago was it?
4. What dog care responsibilities did you have?
Please list all animals that currently live in your household.
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As you do describe your animals:
Provide the type/breed, the sex or if altered, the age and the years you have owned the animal and where you keep the animal.
Past Dogs in your life.
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Please describe and list any dogs you have owned in the past and explained what happened to them:
1. Type/Breed, Sex, Altered?
2. Age, Years Owned with dates and what happened to the dog.
What did you like most and least about dog ownership?
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1. Of the dogs that you own or have owned, what do
you enjoy most about dog ownership?
2. What do you like least about dog ownership?
Training or behavior issues with your dogs
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1. Have you ever trained a dog or more dogs?
2. Have any of your dogs had puppies or fathered a liter? Describe
3. Have you ever owned a problem dog? Please describe.
4. What experience, if any, have you had with dog aggression?
5. Have you had any complaints from others about your pets?
Dog Experience
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1. Based on your past dog experience, is there anything you might do differently with your next dog?
2. How will you safely introduce and integrate a Kerry with your existing pets?
Additional Information
Please provide any information or anecdotes about your current or previous dogs that may be relevant to adopting a Kerry Blue Terrier.
Your Home
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Which of the following best describes your current residence:
Does your town or city have any restrictions on the number of dogs you can have?
Rent/Lease
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If you rent/lease, is your landlord agreeable to your owning a dog?
Home Owners Association
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Does your lease or homeowners association have any covenants or restrictions on pet ownership? (Copy of lease will be needed for adoption finalization.
City or Town
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Does your town or city have any restrictions on the number of dogs you can have?
Neighbors
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Would any of your neighbors object to your getting a dog?
Your Yard
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1. Is your back yard completely and securely fenced? Yes or NO and if no, explain how you plan to exercise your dog and allow it to relieve itself.
2. Give the type of fence and height of fence. Is it secure and solid?
3. What type of gates do you have? Do all the gates have locks?
4. Can children open the gates?
5. Can a dog dig under the fence?
6. If you have a pool, is it fenced?
7. If you have a dog run, is it secure? Is it shaded?
8. Does your yard contain any plants poisonous to dogs? (Before answering see Poisonous Plants to dogs at: https://www.aspca.org/pet-care/animal-poison-control/toxic-and-non-toxic-plants?field_toxicity_value%5B%5D=01
More about your Yard
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1. Does your yard contain any objects of landscaping that the dog could use to climb a fence? Describe.
2. Are there any dangerous articles in your yard that could harm a dog? Please describe.
3. What types of improvements are needed to provide a secure yard?
4. Are you willing to make these improvements? How long will it take?
5. What distractions are you aware of outside your yard that could plague a dog (like a neighbor's dog or cat, loose dogs, mischievous children...)
6. Do you allow friends, relatives and children to gain admittance to your home, property and car without your knowledge or supervision?
7. Can service people or strangers gain access to your yard without your knowledge or supervision?
Care and Responsibility of your Dog
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1. Is someone normally at home most of the day?
2. How many days will the dog be alone in a normal work week and how many hours each day?
3. How much time do you have to spend with your Kerry on a normal workday?
Where will your Kerry be?
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Where will your Kerry Spend the day while you are at work?
Routine for your Kerry
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1. Will there be some protection from the elements when outside?
2. Where will the dog sleep at night? Be specific
3. What routine family activities will your dog participate in?
4. How regularly (daily, weekly, or monthly) and for how long (miles or minutes) will the dog be exercised?
Grooming
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1. Will your dog be professionally groomed? Please provide the Groomers Name, Shop and location with phone number.
2. If not professionally groomed, who will groom the dog, and how often?
Cost of Grooming
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Do you have the time and are you physically able, financially prepared, and willing to...
1. Pay someone up to $65 or more to groom your Kerry?
2. Or you financially able to purchase a grooming table, clippers, scissors and other accessories ($250-$300 investment) and devote to the time to learn to groom your Kerry yourself?
3. Are you prepared to spend approximately one hour each week brushing and combing your Kerry, or more it if gets into Foxtails, burrs or gets wet?
Eye Cleaning
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Are you prepared to clean the eyes of your Kerry every single day if necessary?
Veterinarian Needs
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1. Are you prepared for both the routine cost of veterinarian care (worming, annual shots) and non-routine/emergency veterinarian care, especially as your dog gets older?
2. Do you have a veterinarian you have used before and plan to use with your next dog? Please answer and provide the Vet's name, Clinic, Location and Work phone number.
Behavior and Training Section A
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1. Would you be willing to participate in a formal obedience training program with your Kerry?
2. Have you ever trained one or more dogs before? Yes of No and if yes, list type of training, when, method used and the Instructor.
3. Are you familiar with Crate Training and its dos and don'ts?
Behavior and Training Section B
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1. Are you willing to provide training to resolve behavior problem?
2. What kind of good behavior do you expect of this dog?
3. How would you discipline your dog if he made a mistake?
4. What amount of time and effort do you want to devote to training your dog?
5. How would you describe your attitude about training (firm, tolerant, lenient, etc.)?
6. Have you done any reading on animal behavior
modification/dog training? List any books you have used.
Commitment to your Kerry
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A Kerry Blue Terrier can live to be 15 years, representing a 15-year commitment to you. Consider how old you will be 15 years from now, and how you will feel about this commitment then.
Are you and those living with you committed to spending the next 15 years providing healthcare, food, grooming, training and attention to your Kerry?
Chance of a move?
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Is there a chance that you might move at least once in the next 15 years?
Move Issues
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1. Are you willing to take your Kerry with you, and restrict your choice of housing to places where pets are allowed?
2. Have you carefully considered how the dog will fit into your current lifestyle, and how dog ownership will change your daily routine and schedule?
Lifestyle Issues
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1. What changes do you expect in your lifestyle and daily routine when you own a dog?
2. Is there a possibility that your current lifestyle is so busy you might not have the time or energy to properly care for a Kerry Blue Terrier? Explain.
3. Think about what major changes might happen in your life over the next 15 years: Please address the following.
a. Marriage
b. Divorce
c. Children
d. Job Uncertainty
e. Job Transfer
f. New Career
g. Retirement
4. Are you willing to continue spending the time, energy, and money to care for the Kerry as you deal with these life changes or new responsibilities?
5. What will you do if your spouse or children can’t get along with the Kerry?
6. Are you willing to teach young or inexperienced children how to respect and properly handle a live animal?
7. Are you willing to accept that the dog may not like your friends or those friends of your children?
8. Does everyone in the family want a dog? Explain.
9. What complaints or concerns have been raised?
References
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Provide Names, Phone Numbers and Relationship to Applicant for the following:
1. Please provide three names as references, including your landlord (if you rent your home), and your veterinarian, groomer, or dog trainer (if you have one).
2. If you belong to a dog club or any dog-related group, include the name of an officer or associate.
3. Other references could include a neighbor, your employer, a friend, or relative who owns a Kerry, another terrier, or another high maintenance breed (such as a Poodle or Afghan Hound).
Placement Information
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Thank you for taking the time to complete this questionnaire. We appreciate people who are willing to consider adopting a Kerry Blue Terrier. Your answers will permit us to more effectively match available dogs’ needs with your lifestyle and requirements. To help expedite the process, your Adoption Questionnaire may be shared with other Kerry Rescue Coordinators or Kerry breeders with dogs to place. If you have any comments or concerns about adopting a Kerry Blue Terrier or about our Rescue program, please feel free to share them with us.
The Kerry Blue Terrier Foundation is a nonprofit 501(c)(3) public charity working to ensure the continued welfare of our breed by rehabilitating and placing Kerries and Kerry mixes from various situations, including rescues from shelters. We do not charge for placing Rescue Kerries in new homes. However, to continue our rescue work, we ask for a donation to our organization if we are successful in matching you with a Kerry. You may also need to assume any shipping charges and related expenses regarding the delivery of the dog to you.
In addition, you will be asked to sign an Adoption Contract which requires, among other things, that the dog be returned to the Foundation immediately should you no longer be able to keep it. It may not be sold, transferred, or given to any individual or establishment. In the unlikely event that the dog is unaltered, you will be required to have it spayed or neutered within 90 days of adoption. Under no circumstances should the dog be bred. You will also be required to take the dog to a veterinarian within 3 days of the date of the Adoption for a checkup and any necessary medical treatment.
The Foundation makes no representation as to the physical condition, temperament, habits, personality features, or other aspects of the dogs available for adoption. The Foundation is in no way liable or responsible for any damage, accident, or injury resulting from the adoption of any dog or the future conduct of that dog.
Application
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All of the information I have provided in the questionnaire is true and complete to the best of my knowledge. I understand that any deliberately false, misleading, or omitted information that may affect a placement decision is grounds for removal of a dog from my possession. Should a Kerry be placed with me, it will reside in my home as a pet. I agree to provide the dog with adequate food, water, shelter, affection, and medical care, and to fulfill the conditions of the Adoption Contract. With this being submitted on line, please type your name for signature. All adoption papers will need signature if approved. Do you agree?
Applicant One Signature by Typing
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First Name
Last Name
Applicant Two Signature by Typing
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First Name
Last Name
Date of application:
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Contact Phone
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