First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

Email*

Home Phone*

Work Phone
x

Cell Phone*

Alt Email

Text/Pager Email

Secondary Applicant's Name *

Your Age*

Do you have a preference for age?
Choose one: puppy young adult senior

Do you have a preference for male or female?
Choose one: male female no preference

Would you consider a special needs dog?
Choose one: yes no no preference

How many people live in the household?

How many children and their ages?*

If no small children in the family now, will there be any in the family soon?*

Do other children visit often?

Who will be the primary caregiver for the dog?

What is your occupation?

What is your spouse's occupation?

Do you have dogs now?*
Choose one: Yes No

If you currently have dogs? YOU MUST LIST NAME, AGE. GENDER, BREED, temperament and any comments about each dog.*

What other dogs have you owned? YOU MUST LIST NAME, AGE, GENDER, BREED

Where are they now?

Have you owned a Great Pyrenees before?*
Choose one: Yes No

Do you have cats? If so, provide their names?*

Do you have other animals or birds? If yes, what kinds of animals do you have?*

Are your pets spayed/neutered?*
Choose one: Yes No

If no, why not

Are all your pets vaccinated now?*
Choose one: Yes No

If no, why not?

Have your pets been on heart worm preventative for the last 6 months?*
Choose one: Yes No

If no, why not?*

Do you live in a house, condo, apartment or other?*
Choose one: House Condo Apartment Other

Do you own or rent your home?*

If renting, please provide landlord name & phone number.

Are you planning to move soon?*
Choose one: Yes No

Does your home have a yard? How big?*

Please describe your fence. TYPE AND HEIGHT.*

Does it completely enclose your yard?*
Choose one: Yes No

Where will the dog spend the day?*

Where will the dog spend the night?*

For how long would all adults be away from the home on a normal day?

Where will the dog be during that time?

Will you be using a crate, and if so for how long at a time?

Great Pyrenees BARK loudly and if you have close neighbors, Great Pyrenees must be kept inside, especially at night. Will this be a problem for you?*
Choose one: Yes No

It is a breed trait to wander. When outdoors and not in a fenced area, Great Pyrenees will not stay with you without a lead. They will not stay in the yard without a fence. Some Great Pyrenees will jump or climb over fences. Will you commit to keeping your Great Pyrenees in a securely fenced yard or on a lead?*
Choose one: Yes No

May we have your permission for a representative of SPIN to visit your home?*
Choose one: Yes No

May we have permission to contact your vet for a reference?*
Choose one: Yes No

Veterinarian Name, Address and Phone Number, if no vet reply N/A*

Do you volunteer or foster for another rescue group? if yes, which group?

Can you commit to the terms of the foster agreement which we will send you to look over? (SPIN pays for vet services if you use our vets, and we provide various medications the dog will need).*
Choose one: Yes No

Can you make your foster dog available to meet potential approved adopters (by appointment only), and furnish SPIN with current photos and description?*
Choose one: Yes No

Feel free to ask any questions.

I certify that all information provided on this application is correct and true.*