Echo Dogs White Shepherd Rescue Online Adoption Application Form

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Name of dog(s) you want to be considered for:

What is your:

Name, Address, City, State, Zip

E-mail address

Phones, (h) (w) (c)

How many persons in your household? (number of adults, number of children, ages of children)

If other chidren visit your home, list what ages and how often?

Is everyone in your household in agreement to add a new pet?
Yes No

Is this pet for you and will you be the primary caretaker of this new pet? Yes No

If not youself, explain below who the dog is for and who will be its primary caretaker.

Have you owned a German Shepherd Dog before? Yes No

Do you currently own any pets Yes No

Please list all current pets (name, species, breed, age sex, and if the pet is spayed or neutered):

Please explain what happened to all previously owned pets & the circumstances:
(i.e. Died from, gave away because, etc)

Do you have any preference as to the sex of your new White German Shepherd? (no preference, Male, Female)

Do you have any preference to the color of your German Shepherd? (White, Black & Tan, Doesn't matter)

Would you consider adopting a mix breed White German Shepherd yes no

What age range would you like to adopt: (under 6 mo,6 mo. to 3 yrs, 3-6 yrs, 7 yrs. & up, any age)

Are you aware that German Shepherds grow big, like 55-100+ lbs? yes No

Do you know that German Shepherds have a double coat and shed a lot? yes No

Explain living arrangements of all your pets and how this new pet will fit in:(Inside, Outside, Both, etc)

If you are applying to foster a dog, do you have places to separate dogs if needed? yes No

Is anyone in your household allergic to pet dander? (yes or no and please explain if yes)

Regarding your residence, do you : (own a single home, rent a single home, own a condo/townhouse,
rent/lease condo/townhouse) And if you rent are you allowed large dogs 55-100+ lbs?

Do you have a fenced in yard where you reside? If you have a fence what is the height and what is the fencing material? (wood, chain link, block, etc). If you answered "no", how will you provide for the dog's exercise?

Approximately how many hours each day will your new White German Shepherd be home alone: (3 hrs. or less more than 3, but less than 6 hrs. more than 6 but less than 8 hrs. more than 8, but less than 12 hrs. more than 12 hrs). And, if more than 6 hours or longer, what provisions will you make for the dog to relieve itself and get exercise during your absence?

Please list your current veterinarian or one you have used in the past. (Name, address, phone number, and length of time you have been using this vet.)

If you currently own a dog, is your dog current on Heartworm prevention? (yes or no, and if not, explain why):

Are your pets current on all vaccinations? (yes or no, and if not explain why):

Please list the name address, phone numbers (including area code) of 3 personal references, other than your veterinarian who are not related to you:

As a part of the adoption process and before placing any dog, you will be asked to sign a contract in which you agree to certain conditions, such as allowing a White German Shepherd Rescue agent to visit your home prior to and after placement of the dog, and surrender back to White German Shepherd Rescue the dog if you violate the contract or are unable to keep the dog for any reason.

Are you willing to sign and be bound by such a contract? yes no

© 2004 Echo Dogs White Shepherd Rescue

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