Adoption Questionnaire

 

 

Version 09-June-16

Thank you for filling out this questionnaire.  Your answers will help us assign an adoption counselor to work with you and match your needs with the dogs in our program.

Please complete this form, then:

  • Print a copy to keep for your reference;
  • Make a second copy to take with you to Adoption Events;
  • Electronically submit this form (see "Submit" button at bottom of questionnaire)
    or
  • Mail a printed copy to:

German Shepherd Rescue of Northern California, Inc.
P.O. Box 1930
Cupertino, CA 95015-1930

First Name:*             Last Name:*
   
Address:*
City: * State:*                 Zip:*
County:
Phone:* Day: Evening: Cell:
Email:*
1. Who will be responsible for the dog’s care? 
Check all that apply and indicate which person will have primary responsibility.
 
Adult
Name:
   
Adult
Name:
   
Child
Name:
Age:
Child
Name:
Age:
Comments:
(max 500
characters including spaces)

   
2. Name and city of your veterinarian:
(max 200
characters including spaces)

 

May we contact your current veterinarian regarding your current or previous pets?

3. Do children live or regularly visit your home?
Please indicate how many children in each of the following age groups:

Live In:
under 1 year
1-3 years
4-7 years
8-12 years
older than 12 years

Visitors:
under 1 year
1-3 years
4-7 years
8-12 years
older than 12 years

4. Please tell us about your current pets and animals, including any livestock.
 
Species:
Breed:
Gender:
Age:
Primary Living Area:
Spayed/Neutered? Where does this animal sleep?
Comments:

(max 200 characters including spaces )
       
Species:
Breed:
Gender:
Age:
Primary Living Area:
Spayed/Neutered? Where does this animal sleep?
Comments:

(max 200 characters including spaces)
       
Species:
Breed:
Gender:
Age:
Primary Living Area:
Spayed/Neutered? Where does this animal sleep?
Comments:

(max 200 characters including spaces)
       
Species:
Breed:
Gender:
Age:
Primary Living Area:
Spayed/Neutered? Where does this animal sleep?
Comments:

(max 200 characters including spaces)
5. What happened to previous dogs you no longer have?
Breed: Age: Disposition:
Comments:  

(max 100 characters including spaces)
 
Breed: Age: Disposition:
Comments:

(max 100 characters including spaces)
 
6. Do you own or rent your home?
     Which best describes your residence?
7. Please describe fencing in the yard or exercise area where your dog will be outside:
8. Indicate height of your fence at its lowest point:
9. Do you have a swimming pool?


10. Please tell us about your personal experience with dogs:






11. Why have you decided to adopt a German Shepherd Dog?

(max 500 characters including spaces)
 
12. Please tell us about your experience training dogs. Check all that apply:
None
Read books and magazines
Attended seminars or took online courses
Pet store classes
Group recreational classes
Private recreational classes
Agility, flyball, other recreational sports classes
Intermediate or advanced classes
Formal advanced training for competitive obedience or dog sports
Earned working titles
Professional level military, service, or law enforcement work
13. What roles do you want the dog to play in your and your family's life? Check all that apply:
Household pet
Companion for adult(s)
Companion for children
Companion for other dogs
Companion for pets other than dogs
Hiking/Jogging Partner
Personal service dog or therapy dog
Protection
Guard dog
Professional working dog (i.e., search & rescue, narcotics or bomb detection)
Other (please explain)
14. What kinds of activities do you want to participate in with your dog? Check all that apply:
Neighborhood walks, backyard games
Visits to dog parks (off leash with other dogs)
Hiking, jogging, or running
Day trips (e.g., to the beach)
Horseback riding
Structured obedience, canine good citizen
Recreational dog sports (agility, flyball, etc.)
Competitive dog sports (obedience, rally, agility, herding, tracking, Schutzhund)
Volunteer working activities (search and rescue, therapy)
Professional working activities (security, protection, narcotics or bomb detection, human remains detection, personal service dog, law enforcement)
Other (please explain)
15. How long will your dog be alone during the typical weekday?




16. Where do you want your dog to spend its time?




17. What type of dog would you prefer?
Gender:     

Age (check all that apply):
Puppy (under 6 months)
Puppy (6 months - 1 year)
Young adult (1 -3 years)
Adult (3 - 5 years)
Adult (5 - 7 years )
Senior (older than 7 years)
18. Do you have any additional comments to help us find the right dog for you?

(max 200 characters including spaces)

19. Would you be interested in joining our team of foster parents and helping a German Shepherd Dog?

20 How did you hear about GSRNC?
Friend Friend
Adoption day or other event
Newspaper
Web search
Veterinarian
Other (please explain)

The average cost of caring for our dogs, including shelter fees, spaying/neutering, veterinary care, boarding and feeding exceeds $650 per dog. We ask for a minimum adoption fee of $400 for a puppy (under one year old), $350 for an adult dog 1 thru 6 years old, $200 for an adult dog 7 years and older and no fee for a dog of any age in the Thulani program to cover these costs. Any additional contribution you are able to make will be much appreciated.

German Shepherd Rescue of Northern California is a non-profit all-volunteer organization..

We thank you for your interest in German Shepherds!