Adoption / Foster Application Adoption / Foster Application Fields marked with an * are required Name * Address * City * US States * - Select State - Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Washington DC ARMED FORCES AFRICA \ CANADA \ EUROPE \ MIDDLE EAST ARMED FORCES AMERICA (EXCEPT CANADA) ARMED FORCES PACIFIC Zip * Divider Contact Information Please provide your contact information. Primary Phone * Secondary Phone Email * Divider What are you interested in? What are you interested in? Type of Care * Adoption Foster Either Type of Dog * Purebred Mixed Breed Either Dog Gender * Male Female Either Ages of Dogs you would consider? (Check all that apply) * Under 1 Year 1-3 Years 3-6 Years Over 6 Years Divider Tell us about you. Please provide some information about you and your family. What is your occupation? * What is your Spouse or Significant Other's Occupation? What are your hours of work? * What is your Spouse or Significant Other's hours of work? Do you have children at home? * Yes No If yes, please provide ages: Why are you interested in a Bernese Mountain Dog, specifically? * Have you ever owned a Bernese Mountain Dog Before? * Yes No If yes, when: Divider Tell us about your home. Tell us about your home. Other Dogs Currently Owned. Please include Name, Breed, DOB and Sex. Any other pets at home? * Yes No If yes, please elaborate: Do you have a fenced yard? * Yes No If yes, please describe the fence: Where do you intend to keep the dog? * Indoors Outdoors Please explain why you chose Indoors or Outdoors: * Does anyone in your house have pet/animal related allergies? * Yes No If yes, please elaborate: Are you willing to let us visit your home? * Yes No Divider Agreeable Are you agreeable to returning the dog should some unforseen circumstance arise wherein you would no longer be able to keep it? Please answer below: * Yes No Divider Signature By submitting this form, you agree that all of the information submitted is accurate to the best of your knowledge. Submitting this form acts as your signature. Recaptcha If you are a human seeing this field, please leave it empty.
