Mid-Atlantic
German Shepherd Rescue
Post Office Box 5
Laurel, MD 20725-0005
(410) 644-7763
Adoption Application
Your answers to these questions will help us match your needs with the
dogs in our
program.
Please fill in all the information and mail it to the address shown
above, or give it to one of our
volunteers. Thank you for your interest
in our organization.
Date: _________________ Mid-Atlantic Tag #____________
Name:
________________________________________________________________
Street Address:
_________________________________________________________
Mailing Address (if
different from Street address): ______________________________
City:
__________________________ State: ___________ Zip Code: ______________
Daytime Phone: _________________
Evening Phone: __________________________
Best time to call:
________________________________________________________
Have you owned a German
Shepherd before? If so please give us a
brief history.
______________________________________________________________________
______________________________________________________________________
Why have you decided to get
a shepherd? ____________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
Have you owned other dogs
before? If so, what happened to
them? _______________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
Why do you want to have a
dog now? ________________________________________
____________________________________________________
Who will be the primary
caretaker of the dog? __________________________________
____________________________________________________
List all plans for this dog
(circle those that apply): pet guard dog obedience
search/rescue
Other (explain):
_____________________________________________________________
Would you prefer a: [_] Male [_] Female [_] No preference
Do you have a color
preference? ________________________________________________
How old a dog are you
looking for? [_] Under 1
year [_] 1-2 years [_] 2-4 years
[_]
Over 4 years [_] No
preference
Do you own or rent your home? ____________ If renting, do
you have the landlord's
permission to keep a dog of this size? ________ Please list the landlord's name
and telephone
number: ___________________________________________________________________
What type of home do you
live in? (circle one) single
home condo townhouse duplex
twin apartment
mobile home Other:
________________________________
How long have you lived as
this address?
_________________________________________
If less than one year,
please list your previous address: _______________________________
If you move, what would
happen to the dog?
______________________________________
___________________________________________________________________________
Do you have a fenced yard?
____________________________________________________
If you don't have a fenced
yard, how will you handle exercise and toilet duties? ____________
___________________________________________________________________________
How many hours a day will
your dog normally be left alone?___________________________
Where will your dog spend
the day? ______________________________________________
Where will your dog spend
the night? _____________________________________________
Have you and your family discussed
the time, energy, and effort required to properly care
for a dog? ___________________________________________________________________
Are
you prepared to assume the financial expenses of owning a dog (routine medical
care,
emergency medical care, food, training/obedience lessons, supplies, grooming,
etc.)? ________
How many children reside in
the home? __________ What are their ages? _________________
Do you own cats? [_] Yes [_]
No. If yes, how many cats are in the
house? ________________
Do you own other dogs? [_]
Yes [_] No. If yes, list breed, sex,
and age: __________________
____________________________________________________________________________
Please list any other
animals you own: _____________________________________________
Do you have a regular
veterinarian? __________ Name/phone:
_________________________
____________________________________________________________________________
Would you be willing to let
a representative of Mid-Atlantic GSR to visit your home by
appointment? [_] Yes [_] No
How did you hear about our
rescue and/or who referred you to Mid-Atlantic GSR? __________
_____________________________________________________________________________
Personal references (list 3
and state relationship to you if any): ___________________________
_____________________________________________________________________________
_____________________________________________________________________________
If you have anything to add,
please feel free to use the space below. _______________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________