printClick here for a printable PDF version of this application or fill out the online form below.

Online Adoption Application

Please make sure you have read our Adoption Guidelines (PDF) and visited our Adoption Information page before filling out and application


* Denotes a required field

Section 1 – About You

*Applicant Name:
(first & last name required)
Co-Applicant Name:
*Address:
 *City:
*State:
 Zip:
Home Phone:
 Work Phone:
Cell Phone:
  
*E-Mail Address:
 Alternate E-Mail Address:

Are you married or single? 

Does everyone in your household approve of the adoption?  yes  no

Do you own or rent? 

How long have you lived there?

If you do NOT own your home, please include a copy of your rental/lease agreement with landlord name and telephone number with the application.  We will contact all landlords to verify pet policies.

Employment Information

Employer Name:
 Employer Address:
City:
 State:
Zip:
 Telephone Number:
Number of years with employer?
  
   

Others living with you, or those who are frequent visitors to your home (defined as 1 or more visits per week). 

Person #1:

Name:
 Relationship:
Age:
 Living with or visitor?

Person #2:

Name:
 Relationship:
Age:
 Living with or visitor?

Person #3:

Name:
 Relationship:
Age:
 Living with or visitor?

Person #4:

Name:
 Relationship:
Age:
 Living with or visitor?

Section 2 – About Your Ideal German Shepherd Dog

How did you hear about SGSD Rescue?

Have you applied for a dog with another Rescue Group?  yes  no 

If yes, which one(s)?

Do you have prior experience owning and/or handling German Shepherd Dogs? (explain)

Why are you interested in German Shepherd Dogs as a breed?

What other breeds are you considering and why?

Name of dog(s) interested in:

Why did you choose this dog?

If this dog is unavailable, are you interested in other dogs we may have available? 
 yes  no 

Are you willing to wait if a dog is not immediately available?   yes  no

Would you consider a special needs dog, such as one who requires medication for a permanent but controlled condition (for example: allergies)?  yes  no    

 

Preferences – Please mark all that apply.  
Sex:  
 Male     Female     No Preference

Color:
 Black/Tan  Black/Silver  Black/Red  White 
Black  Bicolor  Sable  No Preference

Age: 
Under 6 months  6-12 months  1-2 years  2-4 years  4-6 years 
7+years (ask about our Seniors-For-Life program)   No Preference

 

Why are you adopting a pet? 
 For me/my family  As a gift  For protection 
 As a companion for another animal  Friend/family have/had one 
 For breeding  Working dog    Other: (Please sepcify)

Please list the top THREE characteristics (in order of importance) you are looking for in your new companion (i.e.: protective, active/playful, aggressive, friendly, good with kids, calm etc…)
1:

2:

3:

Section 3 – About Your Household

Are there any circumstances (health, family, professional, financial) or planned circumstances (new baby, plans to move houses etc.) that could result in your being unable to take care of this dog? 
 yes  no 
If yes, what are they? 

If there are children in or visiting your home, how will you educate and train the children in appropriate ways to treat and interact with a dog?

Do you have a formal provision for the dog in the event you are no longer able to care for him/her?  yes  no  

If not, will you agree to make such provision immediately after adoption?
yes  no  

Do you (or anyone else in the household) have asthma or allergies to animals? 
yes  no           

Have you ever sold, surrendered, or given away a pet? 
yes  no 
If yes, please provide details.

What circumstances, in your mind, justify giving away or surrendering a pet? 

What will you do with the animal if you move, marry, have a baby, or make other significant changes in your life circumstances?

Are you willing to provide pet care for the next 10 years (or more) including vet checks, vaccinations, boarding, medical care (including monthly heartworm preventative), indoor housing, etc?  yes  no 

What do you expect to pay for annual pet care? 

Are you aware that GSDs are very active and that they shed year-round? 
yes  no 

Will you groom the dog yourself?  yes  no    Use a groomer?  yes  no 

Are you familiar with the animal control regulations in your area?  yes  no  

Do you agree to abide by these regulations?  yes  no   
Briefly, what are these regulations?

Have you ever lost a pet, had one disappear, or die at an early age (dogs dying before age 10)?  yes  no 
If yes, please provide details.

Please list all current pets and those you have owned over the last 10 years.  If none, list pets owned in childhood.  List ALL animals currently living with you, even if you do not own them.  If deceased, when did the pet die, how old was the pet when it died, please explain cause of death.

Pet #1:

Name:
Breed:
Gender:
 Age:
Spayed/Neutered:
 Years Owned? (ex: 1995-2000)
What Happened to the pet?

Pet #2:

Name:
Breed:
Gender:
 Age:
Spayed/Neutered:
 Years Owned? (ex: 1995-2000)
What Happened to the pet?

Pet #3:

Name:
Breed:
Gender:
 Age:
Spayed/Neutered:
 Years Owned? (ex: 1995-2000)
What Happened to the pet?

Pet #4:

Name:
Breed:
Gender:
 Age:
Spayed/Neutered:
 Years Owned? (ex: 1995-2000)
What Happened to the pet?

Pet #5:

Name:
Breed:
Gender:
 Age:
Spayed/Neutered:
 Years Owned? (ex: 1995-2000)
What Happened to the pet?

Are your dogs (past and present) on heartworm preventative?  yes  no 

Have you ever had a dog diagnosed as having heartworm?  yes  no

Section 4 – About Your Daily Routine

Please be very specific and detailed regarding the following information.

Please tell us about yourself and your family, including any special activities your dog would be included:

Who will be the primary caregiver?

Where will the pet be kept during the day?

Is anyone home during the day? yes  no 

If yes, who?  

How many hours will the dog be without humans during any time period?

Where will the pet be kept during routine absences (trips to the grocery store, movies, etc.)?

Do you have a kennel run? yes  no

Doghouse? yes   no      

Tie-out stake? yes  no 

If yes to any of the above, how often is it used and under what circumstances?

How do you plan to exercise your pet? (provide details)

Is your yard fenced?  yes  no 

How high is the fence and what type is it?

Have you ever trained a dog? yes  no 
Explain briefly:

Are you willing to enroll in obedience classes? yes  no 

Are you willing to take the time to work with a dog that is not housebroken?
yes  no 

How much time are you willing to give the dog to adjust to its new environment and family members?

If the dog didn’t adjust in that timeframe what would you do?

If you adopted a dog that chews, digs, or has other bad habits, what would you do? 

If your adopted dog developed a serious health problem, what do you think your limitations would be?

May a representative of SGSD Rescue visit your home prior to an adoption? 
yes  no

Are you willing to travel to pick up your adopted dog? 
yes  no

Section 5 – References

May we contact your veterinarian?  yes  no 
Please notify your veterinarian that we will be contacting them and give the office permission to release your records to us.

Vet Name:
 Vet Address:
City:
 State:
Zip:
 Telephone Number:
Name of Pets treated:

Please provide three additional references (not related to you):

Reference #1:

Name:
 Evening Telephone:
Relationship:
 How long known:

Reference #2:

Name:
 Evening Telephone:
Relationship:
 How long known:

Reference #3:

Name:
 Evening Telephone:
Relationship:
 How long known:

By checking the box below, you verify that you are 21 years of age and the you have read the Serendipity German Shepherd Dog Rescue Adoption Guidelines and certify the information provided in this application is accurate to the best of my knowledge.

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