The questions below are meant to help you 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 a Kerry, 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! Extra blanks are provided for additional comments. When you are finished, please send it to Gail Traughber at gtraughber@gmail.com
Name ________________________________________________ Address _____________________________________________ _____________________________________________________ Home Phone __________________________________________ Work Phone __________________________________________ Email _______________________________________________ How long have you lived at your current address? ________ If you have a second home, please provide: Address ______________________________________________ ______________________________________________________ Phone ________________________________________________ Please list every person who currently resides at your residence. Name Relation to You Age ________________________ _______________________ ______ ________________________ _______________________ ______ ________________________ _______________________ ______ ________________________ _______________________ ______ ________________________ _______________________ ______ Who will be primarily responsible for the dog's care and training? ________________________________________________________________________ Does anyone in your household have any known allergies to animals? Yes No If yes, please explain ___________________________ ___________________________________________________________________
Please check any preferences. (Note that the age and pedigree of dogs rescued from animal shelters cannot be verified.) Male Female No preference Puppy Adult No preference Purebred Kerry mix No preference Any other preferences?_________________________________________________ Are you willing to consider a dog: --with special medical or nutritional/dietary needs? Yes No --who was abused or neglected and needs extra love and attention? Yes No --with behavior problems that may require special training? Yes No Comments? ________________________________________________________ How long are you willing to wait for 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? ________________________________ _______________________________________________________________________ Have you and your family discussed the pros and cons of owning a Kerry Blue Terrier? Yes No ____________________________________________________ What concerns do you have about the breed? ____________________________ _______________________________________________________________________ Are you familiar with the temperament and characteristics of terriers in general and Kerries in particular? Yes No Explain __________________________________________________________ __________________________________________________________________ Please explain your experience and understanding of the breed. _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ Have you previously owned a Kerry Blue Terrier? Yes No If yes, when did you acquire it? Year ____________________________ Breeder's name ___________________________________________________ Location _________________________________________________________ Have you personally met a Kerry Blue Terrier? Yes No If yes, please describe __________________________________________ __________________________________________________________________
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 animals that currently live in your household. Type/Breed Sex Altered? Age Years Where do you keep owned the dog? ______________ ___ Yes No ____ ____ ____________________ ______________ ___ Yes No ____ ____ ____________________ ______________ ___ Yes No ____ ____ ____________________ ______________ ___ Yes No ____ ____ ____________________ ______________ ___ 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 owned owned this dog? ______________ ___ Yes No ____ ____ ____to_____ ___________________ ______________ ___ Yes No ____ ____ ____to_____ ___________________ ______________ ___ Yes No ____ ____ ____to_____ ___________________ ______________ ___ Yes No ____ ____ ____to_____ ___________________ ______________ ___ Yes No ____ ____ ____to_____ ___________________ Of the dogs that you own or have owned, what do you enjoy most about dog ownership? _______________________________________________________________________ _______________________________________________________________________ What do you like least about dog ownership? ___________________________ _______________________________________________________________________ _______________________________________________________________________ Have you ever trained one or more dogs? Yes No Have any of your dogs had puppies or fathered a litter? Yes No If yes, please describe __________________________________________ __________________________________________________________________ Have you ever owned a "problem" dog? Yes No If yes, please describe __________________________________________ __________________________________________________________________ What experience, if any, have you had with dog aggression? _______________________________________________________________________ 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? _______________________________________________________________________ _______________________________________________________________________
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 lease or home owners association have any covenants or restrictions on pet ownership? (A copy of the lease will be requested before an adoption is finalized.) Yes No __________________________________________________ Does your town or city have any restrictions on the number of dogs you can have? Yes No __________________________________________________ Would any of your neighbors object to your getting a dog? Yes No
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 ________________ Does your yard contain any plants known to be poisonous to dogs? Yes No If yes, please list ______________________________________________ __________________________________________________________________ Does your yard contain any objects or landscaping that the dog could use to climb the fence? Yes No If yes, please describe __________________________________________ __________________________________________________________________ Are there any dangerous articles in your yard that could harm a dog? Yes No If yes, please describe __________________________________________ __________________________________________________________________ What types of improvements are needed to provide a secure yard? _______________________________________________________________________ Are you willing to make the improvements? Yes No _____________ If yes, when and how long will they take? ________________________ What distractions are you aware of outside your yard that could plague a dog (such as a neighbor's dog or cat, loose dogs on street, mischievous children)? _______________________________________________________________________ Do you allow friends, relatives, and children to gain admittance to your home, property, and car without your knowledge or supervision? Yes No Can service people or strangers gain access to your yard without your knowledge or supervision? Yes No
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: Groomer's 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 __________________________________________________ --Pluck 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 veterinarian 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 _______________________________________________________
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 _____________________________________________________________ Where ____________________________________________________________ Method ___________________________________________________________ Instructor _______________________________________________________ Are you familiar with crate training and its dos and don'ts? Yes No ____________________________________________________ Are you willing to provide training to resolve behavior problems? Yes No ____________________________________________________ What kind of good behavior do you expect of this dog? _________________ _______________________________________________________________________ _______________________________________________________________________ How would you discipline your dog if he made a mistake? _______________ _______________________________________________________________________ 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 behavior modification/dog training? Yes No If yes, please list the books you have read ________ __________________________________________________________________
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? Yes No _________________________________________ Divorce? Yes No __________________________________________ Children? Yes No _________________________________________ Job uncertainty? Yes No __________________________________ Job transfer? Yes No _____________________________________ New career? Yes No _______________________________________ Retirement? Yes No _______________________________________ 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 ____________________________________________________ What will you do if your spouse or children can't get along with the Kerry? _______________________________________________________________________ If you're getting a pet for children you have now, 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? Yes No ____________________________________________________ Are you willing to accept that the dog may not like all your children's friends? Yes No ____________________________________________________ Will you still want the Kerry after the kids have grown up and moved out? Yes No ____________________________________________________ Have you previously owned a pet that didn't live with you for 10 years or more? Yes No ____________________________________________________ If yes, what happened to it? _____________________________________ __________________________________________________________________ What will you do differently with this pet to prevent it from going the way your previous pet did? _____________________________________________________ _______________________________________________________________________ Does everyone in the family want a dog? Yes No What members are enthusiastic? ___________________________________ Unenthusiastic? __________________________________________________ What complaints or concerns have been raised? _________________________ _______________________________________________________________________
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 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).
Name Phone Number Relationship to applicant _________________________ ____________________ ______________________ _________________________ ____________________ ______________________ _________________________ ____________________ ______________________ _________________________ ____________________ ______________________
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. This Kerry Blue Terrier Club is a not-for-profit organization 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 Rescue Fund 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 club 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 Contact for a check up and any necessary medical treatment. The club makes no representation as to the physical condition, temperament, habits, personality features, or other aspects of the dogs available for adoption. The club 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. 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 your 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.
Signature of Applicant ___________________________________________________ Signature of Applicant ___________________________________________________ Date of Application ______________________________________________________ Home phone ______________________ Work phone _____________________________ Email ____________________________________________________________________