| Name of the dog(s) you want to be considered for? |
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| Your name: |
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| Address: |
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City, |
| Phone number: |
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(h)
(w)
(c)
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| Email address: |
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| How many people are in your household? |
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Total
Children
Children's ages
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| Is everyone in your household in agreement to add a new pet? |
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Yes
No |
| Is this pet for you and will you be the primary caretaker? |
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Yes
No |
| If not explain who the dog is for and who is to be the primary caretaker: |
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| Have you owned a German Shepherd Dog before? |
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Yes
No |
| Do you currently own any other pets? |
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Yes
No |
| Please list all current pets (names, species, ages, sex, are they spayed/neutered? |
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| Please explain what happened to all previously owned pets and circumstances (i.e. died, gave away because, etc) |
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| Do you have a preference as to the sex of your new GSD? |
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No preference
Male
Female |
| Do you have a preference as to the color of your GSD? |
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No preference
Black & Tan
White |
| What age range would you like to adopt? |
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Puppy
1 -3 years
3 - 6 years
7+ years
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| Are you aware that GSD's grow big, like 55 to 100+ lbs? |
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Yes
No |
| Do you know that GSD's have a double coat and shed a lot? |
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Yes
No |
| Explain living arrangements and how this dog will fit in? (Inside, outside, both, etc). |
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| Is anyone in your home allergic to pet dander? |
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Yes
No |
| Regarding your residence, do you: |
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Own
Rent
Other
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If other please explain: |
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If you rent are you allowed dogs 55-100+ lbs? |
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Yes
No
(
You will be required to provide proof from your landlord.)
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| Do you have a fenced yard? Please describe (wood, chain-link, etc) including height. |
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| Approximately how many hours will your dog be home alone: |
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1-3 hrs
3-6 hrs
6-8 hrs
8-12 hrs
12+ hrs |
| If more than 6 hours what provisions will be made for the dog to relieve itself and get exercise in your absence? |
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| Please list current Vet or one you have used in the past: |
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Name:
Address:
Phone #:
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| If you currently own a dog is your dog on Heartworm preventative? If not explain: |
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| Are your pets current on their vaccinations? |
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Yes
No |
| References: 3 personal references other than your Vet who are NOT related to you. (name, address, phone number). |
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| Have you or anyone in your household ever been convicted of animal abuse/cruelty? |
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Yes
No
If you answered "Yes" please explain:
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| As part of the adoption process and before placing any dog, you will be asked to sign a contract in which you
agree to certain conditions, such as allowing a WPGSDR agent to visit your home prior to and after placement of the dog, and surrender to WPGSDR the dog if you violate the contract or are unable to keep the
dog for any reason. |
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| Are you willing to take the dog to obedience classes? (Required) |
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Yes
No |
| Are you willing to be bound by such a contract? |
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Yes
No |