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Adoption Form
Name
*
First
Last
Address
*
Street Address
Address Line 2
City
County / State / Region
ZIP / Postal Code
Home Phone Number
*
Mobile Phone Number
*
Email Address
*
DOB (Applicant 1)
*
Date Format: DD slash MM slash YYYY
DOB (Applicant 2)
Date Format: DD slash MM slash YYYY
Do you own your property?
*
If rented you must have written permission to keep dog/s at property, this must be shown at home check
Please Select
Yes
No
Please give further details
*
Type of property:
*
Please Select
Flat
House
Bungalow
How long have you lived at this property?
*
Please give details
Garden area:
*
Please Select
Secure garden
Shared garden
Rural property
Garden area - Please give further details
*
Work - Adult 1:
*
Please Select
Full time
Part time
Retired
Not employed
Work from home
Work - Adult 2:
Please Select
Full time
Part time
Retired
Not employed
Work from home
How long would the dog be left for:
*
Please Select
1-2 hours
2-3 hours
3-4 hours
Won't be left
How would you manage dog care whilst working?
*
Please Select
Take dog to work with you
Use dog walker
Use day care
Come home at break
Do you currently have a dog?
*
Please Select
Yes
No
Is resident dog/s spayed or neutered?
*
Please Select
Yes
No
Please give further details
*
Is resident dog/s in date for vaccination?
*
Please Select
Yes
No
Please give further details
*
Is resident dog/s insured?
*
Please Select
Yes
No
Please give further details
*
Do you have GSD experience?
*
Please Select
Yes
No
Please give further details
*
Have you owned a rescue dog before?
*
Please Select
Yes
No
Please give further details
*
Have you been home checked by another dog rescue in the last 12 months?
*
Please Select
Yes
No
Please give further details
*
Have you experience of any behavioural issues with a dog before?
*
Please Select
Yes
No
Please give further details
*
Any other pets in the home?
*
Please Select
Yes
No
Please give further details
*
Do you have children or do children visit?
*
Please Select
Resident
Visiting
Please give further details
*
Would a dog live in your home?
*
Please Select
Yes
No
Please give further details
*
Where & how often do you plan to walk your dog?
*
Please give further details
Do you have a vehicle to transport your dog to vets etc?
*
Please Select
Yes
No
What would you do at holiday times?
*
Please Select
Take dog with you
Use kennels
Leave dog with a friend or relative
Get a house-sitter
Do you prefer a dog or bitch?
Please Select
Dog
Bitch
Would you consider adopting a GSD cross breed?
*
Please Select
Yes
No
Is there a colour you wouldn’t take?
*
Please Select
Yes
No
Please give further details
*
What age range would you prefer?
*
Applicants ages and experience may affect age / type of dog GSRS will consider placing with you. Please give further details
At the time of adoption if dog was entire, you agree to pay to have it spayed / neutered iaw adoption criteria?
*
Please Select
Yes
No
Are you registered with a vet?
*
Please Select
Yes
No
Please give further details
*
Additional info you may wish to include:
*
Please give further details
Name
This field is for validation purposes and should be left unchanged.
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