Legacy GSD and More Rescue Adoption Application - NORTHEAST

Adopter Information

Name of the dog you are applying to adopt *

You First Name: *

Your Last Name: *

Your Email Address *

Your address - NO P.O. Box *

City: *

State: *

Zip Code: *

Home Number: *

CELL Number: *

Work Number: *

Household Information

Household Member 1 name (self): *

Household Member 1 age *

Household Member 1 occupation *

Household Member 2 name *

Household Member 2 age *

Household Member 2 occupation *

Please list the names, ages, occupations of any other members of the household *

Do you rent or own your home *

Rent

Own

If you rent, please provide a name and phone number for your landlord. If you own, please enter N/A *

Who is your employer *

Is anyone in your home allergic to dogs *

Are there any ordinances in your city that limit the amount of pets you can own? If yes, please explain *

Adoption Questions

Is your yard securely fenced? *

Yes

What type of fencing and height? if no, please enter N/A *

Where will the pet be kept during the day? *

Where will the pet be kept at night? *

How many hours at one stretch will the pet be without humans each day? *

Are there any children who visit regularly? If so, what are their ages? *

Do you have a plan in place for vacation/away from home care for your pet? *

Yes

What is that plan? *

What will you do with your pet if you move? *

About what do you think pet care costs per year? *

We require all animals adopted from us to be spayed or neutered. Do you have any questions or reservations about this policy? *

Yes

Please list all pets you currently have and ones you have owned in the past ten years, how long you owned them, and what happened to them. *

Are your current pets (if applicable) on monthly heartworm prevention? *

Yes

Are your current pets (if applicable) on vaccinations? *

Yes

Are your current pets spayed/neutered? *

Yes

If you have ever had a pet lost, disappear, or die at an early age, please provide details (dogs dying before age 10). *

Have you ever sold, given away, or surrendered a pet? *

Yes

If yes, please describe the situation.

How do you plan to exercise your dog? *

The animal may not be housebroken. Are you willing to take the time to work with the animal? *

Yes

All dogs go through a major amount of stress when they leave the only home and family they have ever known, leave the only other animals they have ever known, and go into a new home with more strangers and more animals. It would be a lot for anyone- dog - cat - human to handle, some dogs acclimate more easily than others. It is important for all dogs to be given time to decompress and become aware that they are safe in their new surroundings. Please initial if you will you be willing to give them time to become accustomed to their new life: *

If it still does not work out please initial if will you be willing to foster while we find a new home. *

Name and PHONE NUMBER for past/current vet. NOTE: Please contact your vet after filling out this application and give him/her permission to talk to us about the care provided to your pets by them. *

Name of intended vet *

We may require a home visit as part of the application process. Will you comply? *

Yes

Our adoption fee for dogs placed outside the south is $350. This includes all necessary veterinary care, microchip, health certificate and transportation. The adoption fee goes to fund medical care, food and shelter for all of our animals, not merely the one you are applying for, and is non-refundable. Will you comply? *

Yes

Have you applied to adopt from any other organization within the last 90 days? *

Yes

If yes, what is the status of that application?

Is there anything else we should know that would help us to understand your application?

Is your whole family in agreement with adopting this dog or puppy? *

Yes

I understand that the dog I am applying to adopt is STILL IN A SOUTHERN FOSTER HOME. He/she is available in the south, or will be transported to the area he/she is listed in AFTER I adopt. *

Yes

Electronic Signature

I certify that I have carefully read and agree to all the provisions in this application. I have answered all questions as completely and honestly as possible. I understand that if it is discovered that I have falsified any information on this application, my application will be denied. Furthermore, if a dog from Legacy German Shepherd and More Rescue has already been placed in my care, I will be required to immediately surrender the dog and will forfeit the adoption fee. By typing my name below and submitting this application, I am agreeing to all the aforementioned statements (initial) *

Applicant's Signature *

Today's Date: *

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