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Brandie Swanson

Name 2


Home Phone




Email Address


121 Dietrich Ave




IL Illinois

Zip Code


Length of Time at the Present Address

2 years

Adults (Number of people in the household)


Children (Number of people in the household)

10 years and 3 years

Do you rent or own?


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



OSF Home care and Hospice

Names of the animal(s) you are interested in

Lulu, Chuck and Sweet pea

When were you hoping to adopt/foster


Desired characteristics of adoptable animal

Good with children; Energetic; Mellow; Housebroken; Crate trained; age of the animal - young; age of the animal - adult; size of the animal - small; size of the animal - medium; size of the animal - large

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

Companion for me; For a child

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

The last couple months

Is this your first companion animal?


Do you currently have other companion animals?


Current companion animal(s)


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?

I would like my family to be there initially, when we meet each one of them. I feel like we can make all make a decision on which dof fits with us as a family. I don't plan on introducing our dog to any other animals.

Companion animal adjustment period

Yes. I am fully aware that our new dog will need to adjust to our home. That means that there may be accidents or behaviors that take place, and we are prepared to handle that with patience and guidance.

Who is or will be your Veterinarian?

VCA animal hospitals in Woodhull,IL

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


What yearly vaccines will your companion animal receive?

rabies, dhpp (every 3 years)

Do you have any of the following:

training crate; basement; garage

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

Dog will not be left unattended outside

Where will your pet be kept during the day?

In our home

Where will your pet be kept at night?

In our home

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

posisiby a hour

What brand of food will you feed your pet?

Would like advice on whats  best

What are your beliefs regarding spaying/neutering?

I think it is necessary

What are your beliefs regarding obedience training?

I think its great, as long as its good for the dog.

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

My spouse & I

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


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?

We would correct him or her

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

We would probably put him or her in kennel for a "time out"

How would you handle the animal chewing?

​We would correct him or her

How would you handle the animal barking?

By telling him or her "No Bark"

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

​I would first try to think about WHY the animal is doing it, if its not normal for him or her and then put animal in kennel for a "time out"

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


How would you handle the animal shedding excessive hair?

Brush the dog or if it's concerning, take them to the vet

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

Correct the animal by telling him or her "NO" and put him or her in kennel

How would you handle the animal biting/play biting?

I would correct the dog by telling him or her "no bite"

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

I would ask a doctor and vet what I could do to make things better for the person with allergy

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

We wouold handle it accordingly

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

We are buying our current home so that is not a issue right now or for a long time

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

dog will be kept loose indoor

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

Leash walks every day; eventually when fence is put up, the dog will be able to roam freely in fence.

Reference1 - Name

Bonnie Guerin

Reference1 - Phone Number


Reference2 - Name

Courtney Mcgraw

Reference2 - Phone Numner


E-Signature1 | Print Your Name

Brandie Swanson

E-Signature1 | Date


E-Signature2 | Print Your Name


E-Signature2 | Date



Created at 1/25/2016 8:33 AM by  
Last modified at 1/25/2016 8:33 AM by