First and Last Name
Please include your area code.
Please List 2 Personal References
Male Female Either
Black & Tan Black & Silver Black
White Black Sable
Under 1 Year 1-2 Years
2-4 Years No Preference
Which dog are you interested in adopting?
Who is this German Shepherd for?
Have you owned a German Shepherd or any other dog before?
(If Yes, Please provide brief history)
What is it about German Shepherd Dogs that has generated your interest in the breed?
What other breeds have you considered?
What are the three characteristics you find most appealing about the GSD?
Most Appealing Trait
Second Most Appealing Trait
Third Most Appealing Trait
To facilitate the bonding process we recommend every German Shepherd and owner attend some obedience training. Would a formal obedience-training program be something you, as a new owner, would be interested in participating in?
(Please provide a brief explanation)
What kind of work or behavior do you expect of this dog?
What would be your response if he made a mistake?
What amount of time & effort do you want to devote to training him?
What is your definition of disciplining a dog?
What is your initial reaction to the idea of disciplining your dog?
Which of the following best describes your current residence? (Check one)
Own Home Rent/Lease Home Rent/Lease
*(PLEASE NOTE: If you rent/lease your residence a copy of the lease will be requested before the adoption is finalized and you must provide Name & Phone number of the landlord)
Do you have a fence?
No Yes Type of Fencing
Fence Height Type of Gates
Is fence solid & secure? No Yes
Can children open gates? No Yes
What type of improvements are needed to make the yard secure?
Are you willing to make the improvements?
No Yes Not
How long will it take?
If you have a pool, is it fenced? No Yes Not
If you have a dog run is it secure? No Yes Not
If you do not have access to a fenced area, would you like your rescue representative to provide recommendations on the safe confinement of your dog?
Yes Not Applicable No
I have made the following arrangements. (Please describe.)
Have you checked the yard for dangerous articles, plants or anything that the dog could use to climb the fence?
Are there any distractions outside your yard that could plague the dog? (i.e., neighbors dogs, loose dogs on the street, mischievous children)? Yes No
Can children gain access to your yard? Yes No
Approximately how many hours a day will your new German Shepherd be alone?
3 hours or less 3-6 hours 6-12
hours 12-18 hours
Please list the people that currently live at your residence.
(Name, Relationship to you & Age)
Who will have primary responsibility for the care of this German Shepherd?
Have you & your family discussed the pros & cons of owning a GSD? Yes No
Is your life style such that friends, relatives and children gain admittance to your home, property and car without your supervision? Yes No
If you have children are you willing to teach them the proper way to handle a live animal? Yes No
Are you willing to accept that the dog may not like all your children's friends?
Does everyone in the family want a dog? Yes No
What is your families overall reaction to owning a dog?
Which members are enthusiastic?
What members are unenthusiastic and why?
What complaints have been made?
Have you and your family considered that a dog lives for years? Yes No
Are you willing to accept the commitment? Yes No
Have you considered the financial cost of dog ownership? Yes No
Are you financially prepared to give your dog the routine medical care it requires?
Have you carefully considered how the dog will fit into your lifestyle? Yes No
Do you intend to keep the dog primarily indoors or outdoors? Please elaborate.
Where will the dog sleep at night?
What animals currently live in the household? (Please list. Include the following info for each pet: Name of pet, type of pet, sex/age, How long owned? Kept where?)
Have you had any complaints about your pets? Yes No
If yes, please explain.
Does anyone in the household have any known allergies to animals?
If yes, please explain.
Do you have a veterinarian you have used before and plan to use with your new German Shepherd?
If you answered NO to the above question would you like your rescue representative to recommend a veterinarian in your area that is especially knowledgeable about German Shepherds??
How did you find out about our organization? (Please be as specific as possible - Vet, Shelter, Friend, Newspaper,
Internet - what site?, Other)
Would you consider volunteering for our organization
At This Time
If yes, which of the following areas interest you?
Foster Care Personal interviewing of adoption
Transportation of animals Computer Assistance Telephone
Other PLEASE SPECIFY
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