Only submit an application if you live in North Carolina, Virginia or Maryland.
First Name*
Last Name*
Address*
City*
State/Province*
Zip/Postal Code* -
Email*
Home Phone*
Work Phone x
Cell Phone
Alt Email
How many people reside in your household*
Adult #1 Name and Relationship*
Adult #2 Name and Relationship
Child #1 Name and Age
Child #2 Name and Age
Comments & Additions to Household Members
What is your vet's name?
Your Veterinarian's Phone Number:
Pet's Name and Age
Breed
Gender
What is his/her primary living and sleeping area?
Additional Comments
List any other pets that live with you.
What happened to any pets you previously had?
What type of home do you live in?
Do you own or rent your home?
If you rent, have you received the approval of your landlord to have an animal Choose one: Yes No
Please provide contact name and phone number for your landlord if you rent. If you own your home write N/A*
Is your yard fenced?
Type of Fence
How high is your fence? Choose one: Invisible 3 ft. 4 ft. 5 ft. 6 ft. 8 ft.
Tell us about any training experience you have.
How long will your dog be alone during the day?
Where will your dog spend most of his/her time?
Gender Preference
Age Preference
What activities will your dog participate in with you?
Why do you want to adopt a German Shepherd?*
Have you applied with any other rescue* Choose one: Yes No
Other Rescues Applied With
Additional Information
How did you hear obout our organization?
Are you over the age of 18?*