Adoption Application 4.0

Full Legal Name

First NameLast Name

Business Name or Institution Name and department

Address where the dog(s) will reside

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Will the dog live in the same place as you?

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Do you plan on moving within the next six months? If so, when are you moving? Please include the address

Are you completing this form as the owner? If not, please explain your relationship to the owner(s) include your information in this section, owners information in everything else

Best Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Email

example@example.com

Zoning of the property where the dog will live

Do you rent, own, or lease the land where the dogs will live? If you rent, please state the pet rules, and include your landlords name and phone number.

I understand and approve Golden State Great Pyrenees Rescue & Sanctuary to contact my landlord. I will notify my landlord, to give authorization of release of information.

Initials

Do you have frequent visitors, guest, employees etc in your property? Please elaborate

How big is the area where the dog(s) will be?

Is the area where the dog will live fenced? If so, height and type of fencing? If possible include a picture of the fence.

Upload picture of your fence

Are you looking for a pet or a Livestock Guardian?

Predator types and load?

Has any predator attacked any animals? Please explain

What other dogs are currently living in the home where the dogs will be? Specify breed, gender, LGD or pet and if spayed/neutered or why not.

Are you okay with excessive night time barking?

Do you use or plan to use any shock collars, prong collars, choke chains, e-collars, spray collars, physical corrections, no-bark collars, or no-bark devices?

Have you ever surrendered a pet? If so, why?

Have you ever had a pet euthanized? If so, why?

Do you have Inside, outside or feral cats?

Have you ever lost a pet to an accident? If so, what happened?

How do you discipline your dogs and why?

Do any of your pets have reactivity or aggression towards other dogs or animals?

Do any of your pets have any health issues? If so, what are the health issues?

Are you able to separate the pets from the livestock guardians? If no, why?

Please list any other animals in your household including livestock and types of birds and if they free range:

Veterinarian Name, address, phone and email:

I understand and approve Golden State Great Pyrenees Rescue & Sanctuary to contact my veterinarian. I will contact my veterinarian to give authorization to release of information to Golden State Great Pyrenees Rescue & Sanctuary

Print Full Name

Please list the name(s) of any specific dog you are interested in?

Gender and age preference of new dog(s):

Where will the dog spend the day? (describe)

Where will the dog spend the night? (describe)

Who will have primary responsibility for this dog’s daily care?

Do you agree to contact us if you can no longer keep this dog?

Are you willing to let a representative visit your home by appointment?

When you are out-of-town, who will be the primary care giver? Name and Phone

All of the information I have given is true and complete. This dog will reside in my home with me. I will provide it with quality dog food, plenty of fresh water, shelter, affection, annual physical examination, and vaccinations under the supervision of a licensed veterinarian

Type full legal name

Date

Signature

ADOPTION APPLICATION