First NAME

Last NAME

Full ADDRESS

Mobile PHONE

E-MAIL

Own or Rent Your Home? If renting, what are Your restrictions concerning Pets?

Is Your Home City or Rural?

Please describe Your Home, house, apartment, etc.

For exercising Your Ambassador, do You have a yard, a fenced area, an acreage, or have a park, neighborhood for walks, trails, etc.?

Besides Yourself, please list all who live in Your Home, their ages and how you're related.

Do You have experience as a Pet owner, please explain.

Do You currently have Pets? If Yes, please list each one and their ages.

Have You ever had to give up or surrender an Animal?

If so, please explain the circumstances.

Which Ambassador would You choose to be Your Family Member, or What would you consider a Match should We presently not be able to offer Your choice?

Where will Your Ambassador sleep at night?

How many Hours a Day will Your Ambassador need to be left alone? Please explain.

Would You be apposed to a Home check to assure the Ambassador's security?

Each Ambassador is unique and may require special adaptations for their safety.

Please provide 3 personal references not living in Your Home and their Contact Information.

Name, Address, Phone, Email, and Your relationship to this Contact....

(Veterinarian, Friend, Co-worker, Business or Church associate, etc.)

First REFERENCE

Second REFERENCE

Third REFERENCE