First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
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Email*

Home Phone

Work Phone
x

Cell Phone*

Alt Email

Applicant's Date of Birth:*

What is your occupation?*

Do you have a valid Driver's License?

Please list all people residing in the home and their ages; *

Please list all animals currently living in your home (include Type, Breed, Age and Special Needs)*

What is your experience with German Shepherds?*

Do your current pets get along with other dogs?

In what type of home do you live*
Choose one: Single Family Duplex Apartment Townhouse Condominium Mobile Home Military Housing

Do you own or rent your home*
Choose one: Rent Own

If you have a homeowner's association, does it allow German Shepherd Dogs?

If you rent, have you received the approval of your landlord to have an animal*
Choose one: Yes No N/A (not-applicable)

If you rent, please enter your landlord's name and phone number. It is recommended that you check to see that German Shepherds are allowed before applying, as we will verify.

Is your rear yard fenced?

What type of fence*
Choose one: Privacy Chain Link Invisible/Underground Other

What is the height of the fence*

Does your home have a pool?

If your home has a pool, is there a fence around the pool?

Do you have a place to isolate or separate a dog if necessary?*

How many fosters are you able to take at once?*

Do you have any restrictions or preferences regarding a foster dog? *

Does your home have a Dog Door? If so, is it left unlocked when you are not home?*

Are all pets currently in your home spayed or neutered? If the answer is NO, please explain why.*

Are all pets in your home up to date on their vaccinations?

Have your pets been given Bordetella (kennel cough) protection?

Are all pets currently in your home up to date with yearly Heartworm testing and monthly preventatives? If the answer is NO, please explain why.*

Are your pets on monthly flea preventatives? If not, explain why.*

Will the animal be kept inside or outside*
Choose one: Inside Only Outside Only Inside and Outside

Where will the animal be kept when you are not home*

Where will the animal be kept when you are home*

Please provide the name, and phone Number of the Veterinary care provider/s that has/have cared for your previous and current pets. List most current vet first.*