First Name*

Last Name*

Email*

Cell Phone*

Canine's Name:*
Choose an animal: ***Scout ***Snoopy (must be adopted with Woodstock-NEW-VIDEO and Woodstock-NEW-VIDEO) Beau-NEW Finley Hattie Jasper-NEW Judy - Fagin's Haven Mindy - NEW Mork - NEW Naomi - NEW Nixon-NEW Peggy Sue - NEW Pepper - NEW Roland - Fagin's Haven Roselyn - Fagin's Haven Winston-NEW Woodstock-NEW-VIDEO (must be adopted with ***Snoopy and ***Snoopy)

Any special needs?*
Choose one: None On-going medication Special diet required Amputation Blind Hearing Impaired Has Allergies Drools excessively

Housetrained:*
Choose one: yes no unknown

Reason not housetrained:
Choose one: Still a puppy Lived only outside Ill/sick Special needs In progress (going well) In progress (doing poor)

Does this dog require a yard?*
Choose one: yes no

Reaction to new people:*
Choose one: Cautious Friendly Protective Aggressive

Activity level: *
Choose one: Not active Slightly active Moderately active Highly active

Energy level:*
Choose one: Low Moderate High

Exercise needs:
Choose one: Not required Low Moderate High

Obedience training:*
Choose one: Needs Training Has basic training Well trained

Likes to vocalize: *
Choose one: Quiet Some Lots

Ok with cats:*
Choose one: yes no unknown

Ok with dogs:

Ok with kids:*
Choose one: All Older only No Unknown

Good with adults: *
Choose one: All Men only Women only Unknown

Good for senior/elderly: *
Choose one: yes no

Good with farm animals:
Choose one: yes no unknown

Needs companion animal:
Choose one: yes no

Apartment Appropriate:
Choose one: yes no

Hypoallergenic:
Choose one: yes no

Cold Sensitive:
Choose one: yes no

Heat Sensitive:
Choose one: yes no

Personality and behavior qualities: (check all that apply):

Additional Comments:

*** By submitting this form you acknowledge and agree that CCF is the sole and legal owner of this canine(s).