Adoption Application
* Denotes a required field.

PERSONAL INFORMATION

Dog you're interested in:*
How did you hear about us?
If "other", please specify...
Name:*
Address:*
City:*
State:*
Zip:*
How long at this Address?*
E-Mail:*
Home/Cell Phone:*
Best Number to call:*
Best time to call:*
Age:*

In order for us to be able to review your application , we need to know if you are employed, by whom, if you are in-between jobs or self employed. This is a required field for all applicants.
Employer:*
Work Phone:*
Do You Own or Rent:* Own Rent
Type of home:* House Apartment Townhouse Other

If you are renting, please answer the following questions (required fields if you are renting):
Are dogs allowed in the apartment complex or house? Yes No
Please provide the phone number for your Landlord:


If you reside in a house, please answer the following questions (condo/townhome as well if applicable):
Is the yard fenced in? Yes No
How tall is the fence around your property?
Do you have locks on all gates? Yes No
Do you have a pool? Yes No
Is your pool fenced in? Yes No

Do you have children?* Yes No
Please provide ages and if any household members have any allergies:
Gender/Age:
Allergies?
Gender/Age:
Allergies?
Gender/Age:
Allergies?

DOG INFORMATION

Why do you want a rescue dog? *
Why do you want a German Shepherd? *
Where will the dog sleep?*
Will the dog be alone during the day? If so, how long and where will he or she be? *
How much time will the dog spend outside?*
How often do you plan to exercise your dog, and how?*
Do you have a doggie door in your house?* Yes No
Who will be mostly responsible for the dog?*

Who will provide for your pet in the event that you become ill or unable to care for him/her?*
Do you have other pets at home now?* Yes No
(If yes, please indicate breed, gender and age, and if they are spayed or neutered)
Have you had a dog before? * Yes No
If so, what breed?
What happened to it?
Have you ever given away a pet before?* Yes No
If yes, when did this happen? (Year)*
If so, why?
Name and phone number of your Veterinarian?
The minimum adoption donation ranges from $300 to $400. This amount only partially covers the cost of veterinary care, boarding fees, and other miscellaneous expenses involved in the temporary care and adoption of our dogs and is tax deductible.

Prior to placement, all dogs will be spayed or neutered, receive current vaccinations, and are usually microchipped. If not, arrangements will be made on an individual basis.

Special consideration may be given to those willing to adopt older dogs or dogs with physical problems.

We appreciate any additional contribution you may be able to make.

*Denotes Required Field. Please return to top of form if you get an error.

 
If you are interested in any of our dogs please email us or call 714-528-4730, or you may complete an online application and one of our adoption counselors will contact you.

Donations can also be mailed to
Coastal German Shepherd Rescue
P.O. Box 50726, Irvine, California 92619-0726.
And you can help by shopping through any of the sponsor links on our pages. Thank you for your support.

Copyright 2005, Coastal German Shepherd Rescue