Please Copy and Paste to your email

Please Copy and Paste to your email.

Bangor Kerries Adoption Questionnaire

The questions below are meant to help you and I determine if a Kerry is the right breed for you,

and to guide you in thinking about all the ways a dog will impact your life.

The questions address various aspects of dog ownership that should be given serious

consideration before you decide to share your life with any dog. Your answers help us assess

your suitability as a home for one of our Kerries, and to match a dog to your particular lifestyle. Please be

as specific as possible, and answer all questions as completely and truthfully as you can.

It helps us help you!

You and Your Family

Name ____ Please Press Insert Button to type _______________

Address _____________________________________________

____________________________________________________

Home Phone _________________________________________

Work Phone __________________________________________

Email _______________________________________________

________________________________________________________________________

Preferences,

Please star-sign (Shift-8) any preferences.

Male Female No preference

Puppy Adult No preference

Any other preferences?_________________________________________________

Why a Kerry?

How did you first learn about the Kerry Blue Terrier breed?

_______________________________________________________________________

What attracted you to the Kerry Blue Terrier?

_______________________________________________________________________

How would you describe the ideal dog for you and your family? (Please be

as specific as possible.) _____________________________________________

_______________________________________________________________________

What other breeds have you considered? ________________________________

_______________________________________________________________________

Are you familiar with the temperament and characteristics of terriers

in general and Kerries in particular? Yes No

Explain __________________________________________________________

__________________________________________________________________

Have you previously owned a Kerry Blue Terrier? Yes No

If yes, when did you acquire it? Year ____________________________

Breeder's name ___________________________________________________

Location _________________________________________________________

Dog's Temperament ________________________________________________

If no, have you personally met a Kerry Blue Terrier? Yes No

If yes, please describe __________________________________________

__________________________________________________________________

Pet Ownership

Why do you want a dog? ________________________________________________

_______________________________________________________________________

Do you have any reservations about dog ownership, the commitment, responsibilities,

the work, and resources required? Yes No

If yes, please describe __________________________________________

__________________________________________________________________

Have you ever owned a dog before? Yes No

If no, have you ever lived in a household with a dog? Yes No

How long ago? _________________________

What dog care responsibilities did you have? __________________________

_______________________________________________________________________

Please list all the dogs or cats that currently live in your household.

Type/Breed Sex Altered? Age Years Where do they stay?

______________ ___ Yes No ____ ____ ____________________

Please list any dog you have owned in the past and explain what happened to it.

Breed Sex Altered? Age Years Dates What happened to it?

______________ ___ Yes No ____ ____ ____to_____ ___________________

Have any of your dogs had puppies or fathered a litter? Yes No

If yes, please describe __________________________________________

__________________________________________________________________

Have you ever had any complaints from others about your pets? Yes No

If yes, please describe __________________________________________

__________________________________________________________________

Based on your past dog experience, is there anything you might do differently with

your next dog? Yes No

If yes, please describe __________________________________________

__________________________________________________________________

How will you safely introduce and integrate a Kerry with your existing pets?

_______________________________________________________________________

Your Home

Which of the following best describes your current residence?

Own a single family home

Rent/Lease a single family home

Own a townhouse/condo

Rent/lease a townhouse/condo/apartment

Other _________________________________________________________

If you rent/lease, is your landlord agreeable to your owning a dog? Yes No

Does your town or city have any restrictions on the number of dogs you can have?

Yes No __________________________________________________

Would any of your neighbours object to your getting a dog? Yes No

Your Yard

Is your back yard completely and securely fenced? Yes No

If not, please explain how you plan to exercise your dog and allow it to

relieve itself? __________________________________________________

Type: ________________________________________ Height: ________________

Is the fence secure and solid? Yes No

What type of gates do you have? _______________________________________

Do all the gates have locks? Yes No __________________________

Can children open the gates? Yes No __________________________

Can a dog dig under the fence? Yes No _______________________

If you have a pool, is it fenced? Yes No _____________________

If you have a dog run, is it secure? Yes No __________________

Is it shaded? Yes No ________________

Are there any dangerous articles in your yard that could harm a dog? Yes No

If yes, please describe __________________________________________

__________________________________________________________________

What distractions are you aware of outside your yard that could plague a dog

(such as a neighbour’s dog or cat, loose dogs on street, mischievous children)?

Care & Responsibility

Who will be primarily responsible for the dog's care and training?

(Children under 11 years can not be expected to look after and train a dog.)

_________________________________________________

Is someone normally at home most of the day? Yes No

How many days will the dog be alone in a normal work week? _________ days

How many hours per day? _________ hours

How much time do you have to spend with your Kerry on a normal workday?

_______________________________________________________________________

On a normal free day? ____________________________________________

Where will your Kerry spend the day?

Loose indoors

Basement

Crate

Garage

Kennel run

Loose outdoors in fenced yard

Tied up outside

Other __________________________________________________________

Will there be some protection from the elements when outside? Yes No

Where will the dog sleep at night? (Please be specific.) ______________

_______________________________________________________________________

What routine family activities will your dog participate in?

_______________________________________________________________________

How regularly (daily, weekly, or monthly) and for how long (miles or minutes)

will the dog be exercised? ____________________________________________

_______________________________________________________________________

Who will be responsible for exercising the dog? _______________________

Do you travel frequently? Yes No _____________________________

Who will take care of your dog while you are away? ____________________

_______________________________________________________________________

Will your dog be professionally groomed? Yes No

If yes:

Groomers Name ___________________________________________________

Grooming Shop ____________________________________________________

Location _________________________________________________________

Work Phone _______________________________________________________

If not, who will groom the dog? _____________________________________

Approximately how often will the dog be groomed?

Bathing _____________________________________________

Brushing/comb out ___________________________________

Trimming ____________________________________________

Do you have the time, and are you physically able, financially prepared, and

willing to:

--Pay someone up to $65 or more to groom your Kerry?

Yes No __________________________________________________

--Purchase a grooming table, clippers, scissors, and other accessories ($250-$300

investment) and devote the time to learn to groom your Kerry yourself?

Yes No __________________________________________________

--Spend approximately one hour each week brushing and combing out your Kerry,

or more if it gets into foxtails, burrs, or gets wet?

Yes No __________________________________________________

--Clean out the hair growing inside the Kerry's ear canals every month to prevent

ear infections?

Yes No __________________________________________________

--Clean the eyes of accumulated matter every single day if necessary?

Yes No __________________________________________________

--Pay for the cost of both routine veterinary care (worming, annual shots)

and non-routine/emergency veterinary care, especially as the dog gets older?

Yes No __________________________________________________

Do you have a veterinarian you have used before and plan to use with your next dog?

Yes No If yes:

Veterinarian's Name ______________________________________________

Clinic ___________________________________________________________

Location _________________________________________________________

Work Phone _______________________________________________________

Do you plan on continuing the puppy insurance that comes with the dog?

yes/ no / will look into it further.

Behaviour & Training

Would you be willing to participate in a formal obedience training program with

your Kerry? Yes No

Have you ever trained one or more dogs? Yes No If yes:

Type of training _________________________________________________

When _____________________________________________________________

Method ___________________________________________________________

Instructor _______________________________________________________

Are you familiar with crate training and its dos and don'ts?

Yes No ____________________________________________________

Are you willing to provide training to resolve behaviour problems?

Yes No ____________________________________________________

What amount of time and effort do you want to devote to training your dog?

_______________________________________________________________________

How would you describe your attitude about training (firm, tolerant, lenient, etc.)?

_______________________________________________________________________

Have you done any reading on animal behaviour modification/dog training?

Yes No If yes, please list the books you have read ________

__________________________________________________________________

What behaviour problems have you solved through training? ______________

_______________________________________________________________________

Commitment

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 health care, food, grooming, training, and attention to your Kerry?

Yes No ____________________________________________________

Is there a chance that you might move at least once in the next 15 years?

Yes No ____________________________________________________

Are you willing to take your Kerry with you, and restrict your choice of housing

to places where pets are allowed?

Yes No ____________________________________________________

Have you carefully considered how the dog will fit into your current lifestyle,

and how dog ownership will change your daily routine and schedule?

Yes No ____________________________________________________

What changes do you expect in your lifestyle and daily routine when you own a dog?

_______________________________________________________________________

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? Yes No

Explain __________________________________________________________

Think about what major changes might happen in your life in the next 15 years.

Marriage? Divorce? Children? Job uncertainty? Job transfer? New career? Retirement?

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?

Yes No

If you're getting a pet for children you have now,

How old are they now?_____ Children under 11 years can not be expected to look after and train a dog.

How old will they be in 15 years?_____

Are you willing to teach young or inexperienced children how to respect and

properly handle a live animal?(Young children must never be left alone with any dog)

Yes No ____________________________________________________

Will you still want the Kerry after the kids have grown up and moved out?

Yes No ____________________________________________________

Does everyone in the family want a dog? Yes No

References

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). If you belong to a dog club or any dog-related group,

include the name of an officer or associate. Other references could include a neighbour, your employer,

a friend, or relative who owns a Kerry, another terrier, or another high maintenance breed.

Name Phone Number Relationship to applicant

_________________________ ____________________ ______________________

Thank you for taking the time to complete this questionnaire.

When you are finished, please send it to kerryb@nb.sympatico.ca