First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

County

Email*

Home Phone

Work Phone
x

Cell Phone*

Alt Email

Driver's License #

Expiration date of identification:

Date of Birth*

Name of Employer? or Self Employed?*

How long have you been employed here?

Please enter the web address of your personal or business website if applicable. If none, please enter "none"*

Please enter your Facebook username below or enter "none"*

Please enter your Twitter username below or enter "none"*

Please enter your Instagram username below or enter "none"*

Do you own or rent your home*
Choose one: Rent Own

Does the Property Owner or Community allow a German Shepherd Dog to live on the property?*

If Applicable, please put Landlord's Name or Community/HOA Name

If Applicable, please put Landlord's phone number or HOA contact number

In what type of home do you live*
Choose one: Single Family Duplex Apartment Townhouse Condominium Mobile Home Military Housing

Is your yard fenced*
Choose one: No Yard No Physical Fence at all Back Yard Fenced (attached to back of house with direct entrance to house) Yard Completely Fenced (fence goes completely around house-direct entrance to house) Kennel area out in yard (no entrance to house)

What type of fence do you have?

What is the height of the fence*

Can a dog dig out under your fence?

I agree to allow BCGSR to visit my home as part of the approval process. I further agree to make any necessary changes before approval is granted. *

Which adult in the household will be responsible for primary care of the dog? *

How many adults reside in your household (over 18) and relationship?*

How many children are regularly in the home and ages? (under 18)*

Do all members of the household know about the new pet and agree? If not, explain.*

Do any household members have any allergies or health concerns related to pets? If so, explain.*

Is anyone in your household a smoker?*

How did you hear about us?*

Have you ever adopted a pet before?

List where you have adopted from before and when you adopted a pet there (year).*

Have you ever given up a pet? If yes, please explain*

Please list the pets you own now. Add the Breed, Name and Age for each one.*

Are all your dogs and cats spayed or neutered? If no, please explain which ones and why.*

Are there any pets in your home now that are NOT owned by you? If yes, please explain.*

Have you applied with any other rescue*
Choose one: Yes No

Have you been approved to adopt with another Rescue? If yes, which one?*

Primary Veterinarian/Practice Name:*

Veterinarian's Address*

Veterinarian's Phone Number:*

Do you now have or have you ever owned a German Shepherd Dog before? If yes, how long and please describe.*

How well do you feel you understand the German Shepherd Dog breed?*

Is there a specific dog you are interested in? Select your first choice. (Selection does not guarantee you will adopt the dog)
Choose an animal: Bandit 0290 Dixie 0625 Drax 0624 Green Jinx Puppy 0612 Mimi 0617

If you selected a particular dog, why? If you have other interests please explain.*

Please select your second choice. (Selection does not guarantee adoption of the dog)
Choose an animal: Bandit 0290 Dixie 0625 Drax 0624 Green Jinx Puppy 0612 Mimi 0617

Please select your third choice of available dogs. (Selection does not guarantee adoption)
Choose an animal: Bandit 0290 Dixie 0625 Drax 0624 Green Jinx Puppy 0612 Mimi 0617

How much time will the animal spend alone during the day*

Will the animal be kept inside or outside*
Choose one: Inside Only Outside Only Inside and Outside

How will you confine your new pet when it is outside? Select all.*

Where will the animal be kept when you are not home*

Where will the animal be kept when you are home*

Where will the animal sleep*

Where do you plan to travel with your pet? *

Please select all the following items you have experience with.

Are you aware of basic vaccination and health needs of pets? Select all you understand completely.

Are you familiar with leash laws, licensing and maximum number of dogs in your locality?

How would you handle destructive behavior from your new pet, such as Chewing, Digging, Scratching furniture, etc.?*

Do you feel you are financially able to care for a new pet if an emergency should arise?*

Do you agree to have your new pet spayed or neutered if not already done?

Do you agree to provide proof of spay/neuter as agreed upon in the Adoption Contract (if not yet spayed/neutered)?

If you are approved to adopt one of our rescues; would you be interested in also becoming a foster?*
Choose one: Yes No

Why do you wish to adopt a rescued German Shepherd? *

Will you agree to sign up and attend a puppy or age appropriate dog obedience class within the first 3 months of adopting your dog? (You may be asked to provide proof of this within the first 6 months after you have adopted.)

Do you agree to provide proof of obedience training?

Please list three personal references (not family members) you have known for at least three years. We will contact them in reference to your relationship with animals.

PLEASE CONTACT ALL YOUR REFERENCES IMMEDIATELY AND LET THEM KNOW WE WILL BE CALLING THEM!

Personal Reference 1: Name*

Personal Reference 1 phone number*

Personal Reference 1 email address*

Personal Reference 2 Name:*

Personal Reference 2 Phone Number*

Personal Reference 2 Email Address*

Personal Reference 3 Name:*

Personal Reference 3 Phone Number:*

Personal Reference 3 Email Address:*

Please list two character references that are not personal friends that have known you for at least five years who would be willing to speak to us.

Please let them know we will be contacting them.

Professional Reference 1 Name:*

Professional Reference 1 Phone Number:*

Professional Reference 1 Email Address:*

Professional Reference 2 Name:*

Professional Reference 2 Phone Number:*

Professional Reference 2 Email Address:*

I certify that the information entered on this applicant is true. Enter your name and date*