First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
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Email*

Home Phone

Cell Phone

Alt Email

Text/Pager Email

At this time, we are extremely full. If you have a dog you need to surrender, please email GS44@aol.com and explain the circumstances. We will help as much as we can. We cannot accept any dogs that have a serious bite history, nor do we have any foster homes for unaltered dogs over 2 years old. Please do not fill out a form as it will delay our response time.

Applicant Name*

rescue use only

Best Phone Number to reach you

What is your dogs name?*

Male or female?*

Is your dog a purebred German Shepherd?*
Choose one: Yes No

What is birth date or age of your dog? *

Has your dog been spayed or neutered?

Where did you acquire your dog?*

How long have you owned this dog?*

Has your dog lived successfully with young children? If yes, what ages and genders? *

Does your dog need a home without kids? If so, why?*

How does your dog act around large dogs?*

How does your dog act around small dogs?*

Has your dog lived with cats? *
Choose one: Yes No

If so, what was the relationship. For example, did they get along well? Did dog chase cat, but not hurt? Did the dog hurt or try to hurt the cat?

If your dog needs a specific type of food, please tell us the type, brands and amount of food your dog eats. *

Does your dog often potty in the house?

Why do you need to give up your dog?*

When does your dog bark?*

What are your dogs best qualities?*

How soon does your dog need to go to rescue*

Is your dog current on his rabies vaccination with vet certificate?

Has your dog been treated for or do you know if your dog has:

Please describe any other condition that requires medical attention.*

Has your dog ever bitten, snapped at or attacked a person, dog, cat, or livestock? if so, please explain the circumstances. *

What are your dog's bad habits?*

Please send a good picture of your dog and a copy of your dog's shot records to: gs44@aol.com . WE CANNOT CONSIDER REHOMING YOUR DOG WITHOUT THIS INFORMATION. I confirm that all the details, answers and information given on this application are true, accurate and complete.

We do NOT require a donation to take your dog. Are you able to make a donation for the care of your dog and others like him that need our help?

Donation amount