Your
name:
Your
e-mail:
Evening
phone:
City
and state you live in:
Personal
references are not asked of you here, but will be requested prior
to adoption.
How
long have you been employed by your current employer? If not currently
employed, please explain.
Do
you have other pets?
choose one
yes
no
who
is your current veterinarian?
vet's
phone:
Do
you prefer a male dog or
a female dog?
choose one
male
female
What
color preference you have for a German Shepherd? (or give the name
of a specific dog on our site that you are interested in)
What
age of dog would you prefer?
Note:
Those considering a senior citizen (dog over 7 years old) may qualify
for medical care financial aid, please ask if interested.
Although
we traditionally first contact you via e-mail, a rescue volunteer
may wish to call you about setting up an appointment to visit with
one of our adoptable dogs. In
general, which weeknight evenings are you available to receive
such a call? How late in the evening may we call you?
Who
is this dog for?
Who
will have primary responsibility for the dog's care?
Does
anyone in your family have allergies to dogs?
choose one
yes
no
Have
you considered the long term commitment of time and financial resources
required for dog ownership?
choose one
yes
no
Have
you and your family discussed the pros and cons of owning a German
Shepherd Dog?
choose one
yes
no
Is
everyone in your family or household (including room mates) enthusiastic
about getting a dog of this type?
choose one
yes
no
Have
you owned a German Shepherd or any dog before?
choose one
yes
no
If
you answered yes to the above question, please provide a brief history
What
is it about a German Shepherd Dog (or a specific dog at our rescue)
that interests you?
What
other breeds have you considered?
What
are the most important characteristics that you would like to see
in a German Shepherd? (examples:
active ,
calm, playful,
intelligent,
loving, protective,
dominant, submissive,
independent)
Note:
Aggressive and severely problematic behavior animals are not put
up for adoption, if they demonstrate any of these behaviors while
in our care.
To
facilitate the bonding process, obedience training is highly recommended.
Would you like to have lessons with your new dog?
choose one
yes
no
How
do you plan to discipline the dog?
Which
best describes your current residence?
choose one
own a house
rent/lease house
own/lease townhouse
rent an apartment
own/lease mobile home
Your
home is located in a:
choose one
large city
large town or suburb
small town
rural area
Note:
If you rent or lease your residence, or live in a Park, proof of
permission to have LARGE dogs will be required before adoption is
finalized. Please provide photocopy of lease if possible.
Do
you have a fenced yard and, if so, please explain the type of
fence, height and number of gates it has
Can
children easily open the gate(s)?
choose one
yes
no
If
your yard is not fenced, do you have a secure dog run?
choose one
yes
no
What
improvements, if necessary, will you make to secure your yard?
If
you do not have access to a fenced area at your home, how do you
plan to exercise your dog and allow your dog to eliminate?
Have
you checked your yard for dangerous articles, plants, or anything
the dog could use to climb and/or jump the fence (i.e.. Dog House,
Picnic Table), or dig under the fence?
choose one
yes
no
If
you have a pool, is it fenced?
no pool
yes
no
Do
strangers (Meter Readers, etc.) require access to the area your
dog will occupy?
choose one
yes
no
Do
friends, relatives and children have access to your home, property
and/or car without your supervision?
choose one
yes
no
Are
you willing to instruct your children and other people that visit
your home on the proper handling and care of German Shepherd Dogs?
choose one
yes
no
Are
there any distractions outside the yard that may disturb and/or
upset your dog? (Neighbor's dog, loose dogs on the street, neighborhood
children)
choose one
yes
no
Approximately
how many hours each day will your dog be alone?
choose one
rarely left alone
1-2 hours
3-4 hours
5-6 hours
7-8 hours
over 8 hours
Do
you travel out of town? If so, how will the dog be cared for during
your absence?
Are
you gone often?
choose one
yes
no
Would
you consider taking the dog with you?
choose one
yes
no
Will
the dog be kept primarily indoors or outdoors?
choose one
indoors
outdoors
Where
will the dog sleep at night?
How
many pets do you currently have?
choose one
none
1
2
3
4
over 4
What
kinds of pets to you have, how old are they, and what is their gender?
Are
all your pets spayed/neutered?
choose one
yes
no
Note:
It
is our policy not to adopt our pets to homes where the other pets
are not already spayed/neutered. If you'd like to adopt, you may,
but will be unable to bring the new dog home until the other pets
are spayed/neutered.
If you show your current pet or are involved in bona fide canine
activities where the dog must remain intact, proof must be supplied
of active participation in a breed club: registration and breeder
references. It is the Central Illinois German Shepherd Dog Rescue's
discretion whether of not we choose to adopt to the given situation.
All
of our dogs are spayed/neutered before they are placed.
Where
did you get each of your pets and how long have you had them?
Where
are your pets kept?
How many
people live in your home?
choose one
1
2
3
4
5
6
7
8
9
How
many are children?
choose one
none
1
2
3
4
5
6+
Please
list the ages of the children
How
did you hear about our organization?
Would you
consider volunteering for our organization? If so, in what way?
Choose which way you would be most interested in volunteering.
You can always volunteer for more later on!
choose one
foster home
bookkeeper
animal transporter
dog walker
obedience buddy
financial sponsor
grant writer
Thank
you for taking the time to complete this questionnaire. You answers
will permit us to more effectively match your needs with dogs
in our program.
If
you have any comments or concerns about adopting a rescued German
Shepherd Dog, about this program and its mission, or any additional
comments or questions you might have: please tell us in the space
below. We are always interested and open to your viewpoint.
We
do reserve the right to refuse any adoption.
