Adoption Application-

German Shepherd Rescue

P.O. Box 8 ~ Elon College, NC 27244

Phone 336-221-0120 ~ LuvMyBentley@aol.com

Dedicated To The Care Of Unwanted and Abandoned ~ German Shepherd Dogs.

Adoption Application

Date:_________________

General Information

Name:__________________________________________________________________

Address:________________________________________________________________

Street City_______________________________________________________________

State Zip_________, ____________

Land lord if

renting;_______________________________Telephone#_________________

Preference: ( ) Male ( ) Female

Age:________________________

Color: ( ) Black/Tan ( ) Black ( ) Black/Red ( )

Black/Silver

( ) Sable ( ) White ( ) No Preference

Reasons for wanting a German Shepherd Dog:__________________________________

Family Structure

Do you have a fenced yard? ( ) Yes ( ) No

If yes, what type and how high?______________________________________________

If not, would you be willing to put up one?_____________________________________

Will the dog be an inside or an outside dog? ( ) Inside ( ) Outside

Where will the dog stay?____________________________________________________

Sleep?______________________________ Exercise?_________________________

Do you have outside shelter for the dog? ( ) Yes ( ) No

Do you have children? ( ) Yes ( ) No

If so, what ages?__________________________________________________________

Who will be taking care of the dog?___________________________________________

Does any family member have allergies to animals? ( ) Yes ( ) No

How much time do you spend at home in a week?____________________________hrs.

How much time do you plan to spend with your dog?__________________________hrs.

How much time are you willing to give your new pet to adjust to his/her new home? ( ) 1 Week ( ) 1 month ( ) More

Other Pet Experiences

Have you ever owned a pet before? ( ) Dog ( ) Cat ( ) No

If a dog, what breed?_______________________________________________________

What happened to it / them?_________________________________________________

What other pets do you have now?____________________________________________

Are they Spayed / Neutered? ( ) Yes ( ) No

Is (was) it / they indoor or outdoor pet(s)? ( ) Indoor ( ) Outdoor

If a dog, was / is it on heartworm preventative? ( ) Yes ( ) No

How do / would you discipline your dog?_______________________________________

Would you be willing to take the dog to obedience school? ( ) Yes ( ) No

Have you ever obedience trained a dog before? ( ) Yes ( ) No

Who is your regular or last vet?______________________________________________

Name_________________________

Telephone number________________

Are you willing to take the responsibility for a dog for the next 10 years ( including annual vet checks,vaccinations, heartworm

preventative, food, extra medical expenses, etc.)? ( ) Yes ( ) No

Are you aware that German Shepherds are active dogs that they require a lot of exercise and that theyshed? ( ) Yes ( ) No

I understand that this is only an application for adoption and that this does not guarantee me a dog. I authorize GSR to do all

necessary reference checks, including landlord and veterinary, ( current and/or previous).I further understand that for any reason

my application my be rejected by the GSR, and my deposit, if any, will be fully refunded.

Signature ____________________________________

Date__________________

Please Return Your Application Along With Your $10.00 Application Fee To:

German Shepherd Rescue

P.O. Box 8

Elon College, NC 27244