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Amanda Jarvis

Name 2

Derek Jarvis

Home Phone




Email Address


2656 w altgeld st




IL Illinois

Zip Code


Length of Time at the Present Address

3.5 yeahs

Adults (Number of people in the household)


Children (Number of people in the household)


Do you rent or own?


If you rent, please provide your Landlord's name & phone number (or a copy of your lease)



Lorna's Laces, Inc.

Names of the animal(s) you are interested in


When were you hoping to adopt/foster

In the next few weeks

Desired characteristics of adoptable animal

Good with all dogs; Energetic; Mellow; Housebroken; Crate trained; age of the animal - puppy; age of the animal - young; size of the animal - small; size of the animal - medium

Reason(s) you are interested in adopting a pet?

Companion for me

For how long have you been considering adopting a companion animal?

Off and on for a couple of yea

Is this your first companion animal?


Do you currently have other companion animals?


Current companion animal(s)

We have a 9 yeah old Red-eared Slider turtle named Taco.

Have you applied to this rescue before?


Have you applied to any other rescue organization before?


1 Name of Shelter


1 Date Applied


2 Name of Shelter


2 Date applied


How do you plan to introduce your companion animal to other animals and/or people in the household?

Our turtle is fully contained so I do not see that being an issue. We do have a studio dog in my office where I would take my dog daily. I would be very open to discussing how best to introduce them to one another.

Companion animal adjustment period

Everyone takes time and patience.

Who is or will be your Veterinarian?

I am uncertain of this yet.

How much money do you anticipate on spending on your new companion animal's annual doctor visits?

roughly $500

What yearly vaccines will your companion animal receive?

heartworn, rabies, bordetella, dhpp

Do you have any of the following:

training crate; deck

What is the longest period of time you would leave your companion animal unattended outside?


Where will your pet be kept during the day?

with me at work or in a crate

Where will your pet be kept at night?

most likely in a crate

What is the most amount of hours the animal will be left alone?

4-5 i would guess

What brand of food will you feed your pet?

most likely natural balance

What are your beliefs regarding spaying/neutering?

i wouldn't consider not doing it.

What are your beliefs regarding obedience training?

a well trained dog is a happy dog. i very much hope to have a well trained dog. aside from it just making for a better companion it is a great way to keep them occupied.

Who will be primarily responsible for feeding/caring for your new pet?

i will

What do you believe is the average life expectancy of a dog/cat?

12-15 yeahs for a dog

How did you hear about our shelter?


Have you ever surrendered an animal into a shelter?


If yes, what were the circumstances?


How would you handle the animal jumping on furniture/counters/tables?

i would allow my dog on furniture. as a general rule of crate training which i have always done in the past the dog wouldn't be unsupervised when it wasn't in its crate.

How would you handle the animal destroying/scratching the furniture?

crate training, providing appropriate chew toys, and preventing boredom. 

How would you handle the animal chewing?

​same as above. 

How would you handle the animal barking?

i truthfully am not sure. my instinct is to ignore the noise and praise when settled down.

How would you handle the animal urinating/defecating where it is not acceptable?

hopefully with proper potty breaks this won't happen but sometimes ​accidents happen. clean it up and move on. 

How would you handle the animal keeping you awake at night?

try to figure out what is causing the disruption and find a solution.

How would you handle the animal shedding excessive hair?

assuming it isn't a medical problem it is just part of having a pet. you clean it up and move on.

How would you handle the animal ruining your favorite article of clothing?

pretty much everything is replacable.

How would you handle the animal biting/play biting?

biting is pretty much an unacceptable behavior. i would have to research how best to handle it though.

How would you handle allergies that a current household member may develop to your new companion animal?


How would you handle medical expenses (emergencies and diagnosis of a medical condition) involving your companion animal?

we are fanancially stable.

How would you handle moving/finding new housing involving your companion animal?

we would take our dogs needs in a home as much into consideration as our own.

When home alone, the dog will be (check all that apply)

in a crate; wire cage

How will you exercise the dog (check all that apply)

Leash walks every day; Will bring to dog park (Public area where dogs can run and play together off-leash); free run of my work studio.

Reference1 - Name

Sally Blandon

Reference1 - Phone Number


Reference2 - Name

Leigh Kelsey

Reference2 - Phone Numner


E-Signature1 | Print Your Name

Amanda Jarvis

E-Signature1 | Date


E-Signature2 | Print Your Name


E-Signature2 | Date



Created at 1/21/2016 3:46 PM by  
Last modified at 1/21/2016 3:46 PM by