Tri-State Shiba Inu Rescue (Application)
Items marked * must be answered
Which Dog are you Interested In?
 
About You
House
Own Rent
Condo
Apartment
Fence Type
None
Electric/Radio
Traditional
*Do children live here or visit? Yes No
About The Dog You're Looking For
Pure Bred Rescue
Male Female
Shiba
Shih Tzu
Age Range
*Will the dog be kept mainly Indoors Outdoors
*Will the dog be Crated Confined to a specific area Allowed free run
*How long will the dog be alone daily
*Do you have other pets
No
Dog(s)
Cat(s)
Other

*Have you previously owned dogs?
Yes No
Will you allow a home vist upon request?
Yes No

Please describe what you are looking for in a pet, any behavior issues you would consider okay, and if
you would consider a “special needs dog”?

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