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Adoption Application Document

Any Questions? Please call us at (302) 650-1710 or (610) 848 0369 or email at tristateshepherdrescue@gmail.com

Contact and Personal Information

Name:

Street Address:

City:

State:

Zip:

Home Phone:

Work Phone:

Cell Phone:

E-Mail:

Dog Interest

Do you know about the $350 Adoption Fee?

Which dog you are interested in adopting?

Employment Information

Employer’s name/number:

Spouse’s Employer/number:

Do you live with:

How old are you?

How old is Your Spouse?

Others including children in the house:

Does every individual in your home know that you are adopting?

Do any individuals in your home have allergies to animals?

How often have you moved in the past 5 yrs?

References: Please provide the name and contact of three references not related to you who can attest to your character.

Name:

Contact:

Name:

Contact:

Name:

Contact:

Please provide name and contact info for all vets in the last ten years. Please give them permission to speak with us.

Living Situation and Lifestyle

Dog’s living situation (check all that apply):

How many hours per day will dog be home alone?

Will the dog be crated inside when alone?

Will the dog be crated inside or an outdoor kennel? If so for how long and when?

Please describe:

Will the dog be kept outside in any form? If, how long and when?

Please describe:

What kind of exercise will the dog have? Fenced yard, leash walks, etc. Please describe:

Home Information

Is the home Urban, Suburban, Townhouse, Rural?

Yard size is:

Is the yard enclosed by a fence?

If Yes:

Height:

Length:

Type of Fencing:

If you are renting, please provide Landlord’s name and phone number for verification:

Landlord Name:

Landlord Phone:

PREFERENCES – WHAT ARE YOU LOOKING FOR?

Please list preferences:

Age:

Sex:

SIZE :

PUREBRED OR MIX:

ENERGY LEVEL - Are you a marathoner or a couch potato? Please give us details of activities you and your family enjoy.

OTHER PETS CURRENT AND PRIOR EXPERIENCE

Please list pets you have currently or have had in the last three years:

NAME:

BREED:

ALTERED :

AGE:

UP TO DATE ON VACCINES?:

WHERE IS PET CURRENTLY? :

NAME:

BREED:

ALTERED :

AGE:

UP TO DATE ON VACCINES?:

WHERE IS PET CURRENTLY? :

NAME:

BREED:

ALTERED :

AGE:

UP TO DATE ON VACCINES?:

WHERE IS PET CURRENTLY? :

NAME:

BREED:

ALTERED :

AGE:

UP TO DATE ON VACCINES?:

WHERE IS PET CURRENTLY? :

Have you ever been convicted of animal cruelty, dog fighting, or other crime relating to animals?

If yes, explain

Have you ever had to give up a Pet for any reason?

If yes, explain

What is your experience with German Shepherds and also with dogs generally?

Additional Information or Comments:

Leave this empty:

Your legal name

Your email address

Please Confirm full name and signature.

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Signed by Tri State Shepherd Rescue
Signed On: August 21, 2024

Timestamp

Audit

August 20, 2024 4:39 am EDT

Adoption Application Document Uploaded by Tri State Shepherd Rescue - support@autowebtech.com IP 49.37.9.237