Language
English (US)
Save Our Setters, Inc.
Dedicated to helping displaced Irish, Gordon, and Irish Red & White Setters
Name
*
First Name
Last Name
Address
*
Secondary Street Address
City
*
State
*
Please Select
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
CAN
OTHER
Please Select
If other:
Zip Code
Home Phone Number
Please enter a valid phone number.
Cell Phone Number
Please enter a valid phone number.
Work Phone Number
Please enter a valid phone number.
Email
example@example.com
Preferred Communication
Home Phone Number
Cell Phone Number
Work Phone Number
Email
With whom are you and your spouse employed, and how long have you worked there?
Are you interested in:
*
Adopt Only
Foster Only
Both Adopt and Foster
Foster to Adopt a Setter coming into the program
In which breed of Setter are you interested? (Irish, Gordon, Irish Red & White, English) NOTE: These are large dogs.
Is there a particular dog on our website in which you are specifically interested? If so, which dog(s)?
Minimum Age
Puppy (3 to 11 months)
Young (1 to 3 years)
Adult (4-6 years)
Adult II (7 to 9 years)
Senior (10+ years)
Maximum Age
Puppy (3 to 11 months)
Young (1 to 3 years)
Adult (4-6 years)
Adult II (7 to 9 years)
Senior (10+ years)
Gender Desired
Male Only
Female Only
Either Male or Female
Would you consider a Setter who requires medication for a controlled condition?
*
Yes
No
Would you consider a Setter who requires special food/diet?
*
Yes
No
Would you consider a Setter who needs obedience training?
*
Yes
No
Are you familiar with or have you researched the breed?
*
Yes
No
Energy level desired
High (pawprints on the ceiling)
Medium (ready to go anytime)
Low (I don't want to get off the couch)
Any of the above
Would you consider a mix?
Yes
No
Members of your household and their age(s):
Do the other members of your household share your interest in adopting/fostering a Setter?
Yes
No
If adopting, who would be the primarily owner (adult, child, elderly)?
Who will care for and exercise the dog?
Does anyone in your household have allergies to pets?
Yes
No
If yes, to what types of pets?
Current Pets in the Household
Do you currently have any dogs?
Yes
No
Do you currently have any cats?
Yes
No
Do you currently have any other pets?
Yes
No
Current Pet # 1
Please Select
Dog
Cat
Bird
Small & Furry
Live Stock
Other
Please list the name of type of one of the pets that you currently own.
Name
Age
Gender
Male
Female
Spayed/Neutered?
Yes
No
Breed and approximate size
Current Pet # 2
Please Select
Dog
Cat
Bird
Small & Furry
Live Stock
Other
Name
Age
Gender
Male
Female
Spayed/Neutered?
Yes
No
Breed and approximate size
Current Pet # 3
Please Select
Dog
Cat
Bird
Small & Furry
Live Stock
Other
Name
Age
Gender
Male
Female
Spayed/Neutered?
Yes
No
Breed and approximate size
Current Pet # 4
Please Select
Dog
Cat
Bird
Small & Furry
Live Stock
Other
Name
Age
Gender
Male
Female
Spayed/Neutered?
Yes
No
Breed and approximate size
Current Pet # 5
Please Select
Dog
Cat
Bird
Small & Furry
Live Stock
Other
Name
Age
Gender
Male
Female
Spayed/Neutered?
Yes
No
Breed and approximate size
Previous Pets in the Household
In the past 5 years only, please.
Have your had any previous pets (not including current one's listed above) in the last 5 years?
Yes
No
Previous Pet # 1
Please Select
Dog
Cat
Bird
Small & Furry
Livestock
Other
Name
Age
Gender
Male
Female
Spayed/Neutered?
Yes
No
Previous Pet # 2
Please Select
Dog
Cat
Bird
Small & Furry
Livestock
Other
Name
Age
Gender
Male
Female
Spayed/Neutered?
Yes
No
Previous Pet # 3
Please Select
Dog
Cat
Bird
Small & Furry
Livestock
Other
Name
Age
Gender
Male
Female
Spayed/Neutered?
Yes
No
Previous Pet # 4
Please Select
Dog
Cat
Bird
Small & Furry
Livestock
Other
Name
Age
Gender
Male
Female
Spayed/Neutered?
Yes
No
Previous Pet # 5
Please Select
Dog
Cat
Bird
Small & Furry
Livestock
Other
Name
Age
Gender
Male
Female
Spayed/Neutered?
Yes
No
What happened to your previous pet(s)?
What veterinary clinic do you use or have you recently used?
What is the veterinary clinic phone number?
Please enter a valid phone number.
If the pets records are not under your name, please provide the name that they are under.
What other veterinary clinics/hospital have you used?
What are their phone numbers?
If the pets records are not under your name, please provide the name that they are under.
Have you given these clinics permission to speak with us?
Yes, I've already called them.
No. but I'll call them today.
No, I do not want you to contact them.
Are their other pets sharing your residence that belong to another, or that visit? (Select all that apply)
Dogs that live here or visit
Cats that live here or visit
Other species that live here or visit
None that visit here, but we visit others
None
How long have you lived at your current address?
Do you rent or own?
Own
Rent
If you rent, what is the name and phone number of your landlord?
What type of home?
Please Select
Single story home with minimal steps
Home with stairs
Condo/Townhouse
Mobile Home
Other
How would you describe your neighborhood?
Urban
Suburban
Semi-Rural
Very Rural
If you own, are their zoning issues that prohibit larger dogs? If you rent, does your landlord permit you to have large dogs?
Yes
No
Not Sure
Will the dog be allowed in the house?
Yes
No
Is an adult family member home during the day?
Yes
No
How long daily will the dog be left alone (without humans)?
Where will the dog stay when you are away for short periods?
Where will the dog sleep?
Are you familiar with the use of a dog crate to train the pet during your absence or at night?
Yes
No
Is your yard fenced?
Yes
No
Partially fenced
What type of fence do you have?
Privacy fence
Chain link fence
Split rail or cattle wire fence
Combination of the above
How tall is your fence?
What is the approximate size of the fenced-in portion of your yard?
If you do not currently have a fence, are you planning on installing one?
Yes
No
If you do not have a fence, how and where will the dog be exercised?
Do you have a pool?
Yes
No
If you have a pool, is it:
In-ground, no fence
In-ground, with fence
Above ground, no fence
Above ground, with fence
Will the dog be walked daily?
Yes
No
Will the dog be exercised in a fenced-in yard?
Yes
No
Will the dog be allowed to run free outside of fence without supervision?
Yes
No
Have you ever taken an obedience course with a dog?
Yes
No
Have you ever owned/fostered a Setter?
Yes
No
Are you aware that Setters are a very active breed?
Yes
No
Who will groom the dog?
Are you aware that routine costs of owning a dog on average is $800 a year?
Yes
No
Have you sold, given away, or surrendered a pet?
Yes
No
If yes, please specify the circumstances:
Please tell us why you want a Setter:
Who referred you to us?
Please tell us a little about your lifestyle, your family, and any special activities in which the dog would be included (if you have any special requirements or requests for a dog, please let us know so that we can more carefully match a dog to your lifestyles).
Has any member of your household ever been cited for leash law violations, animal cruelty, and/or abandonment of animals?
Yes
No
If yes, please specify:
If you are currently working with or have contacted another rescue group, or have ever adopted from a rescue group please tell us which group(s).
By checking this box, I attest that I am of legal age (minimum of 18 years old) to be bound by a contract and that the information provided in this application is true and accurate to the best of my knowledge.
*
Yes
By checking this box, I understand that prior to the placement of a Setter in my home, the above information may be verified. I also agree to a personal interview with a member of the Rescue program, if required, to determine the suitability of my home to care for a Setter. I also understand that completion and submission of this application does not guarantee the adoption of a Setter.
*
Yes
If I elect to adopt I understand that an adoption fee is required.
*
Yes
By checking this box, I grant permission for a representative of Save Our Setters to contact my vet clinic for historical data on my pets, and my landlord regarding pet-related provisions related to my lease agreement.
*
Yes
Applicant's Electronic Signature
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