YOUR INFORMATION

I understand that the provided information will be used for microchip registration.

Name: *

Co-Applicant Name:

Email Address: *

Home Phone: *

Cellular Phone: *

Address: *

City & Zip Code: *

Where are you employed?

Work Phone:

In most cases we require adopters to be at least 21 years of age. Are you 21 years of age or older? Yes, I'm 21 or older No, I'm under 21 *

ABOUT YOUR RESIDENCE

Do you have a fenced in yard? Yes No *

What type of fence do you have? *

How tall is your fence? *

Do you own or rent your residence? Own Rent *

You live in a: House Duplex Apartment Condo Townhouse Mobile Home Other *

If other, please specify

How long have you been at this residence? Less than 1 year 1-3 years More than 3 years *

If you rent, does your landlord/management allow pets?

Please note any limits on the number/size of pets allowed:

PERSONAL REFERENCES

1. Name: *

Phone: *

Email Address: *

2. Name *

Phone: *

Email Address: *

VETERINARY REFERENCE

Please provide us with the vet that has the most up-to-date records for your pets! If you do not currently own a pet but have in the past, please list the vet that provided care for your previous pet(s). Many vets maintain records for several years after a pet has passed away. By providing the following information, you grant us permission to contact your vet for a reference check.

Clinic Name:

Address:

City / State / Zip Code

Phone:

INFORMATION ABOUT YOUR CURRENT AND PAST PETS

Do not list any pets you had as a child or while living with your parents. Please remember, we must be able to verify all information by calling your veterinarian.

Are you first time pet owner? Yes No *

I/We have a cat(s) at our home. They are: Inside Outside Both inside & outside

CURRENT PETS

List ANY other pets currently in your home in the comments section at the end of this application.

PAST PETS

Include all pets owned in the past 10 years, other than those listed above. If you need more space, please continue in the comments section.

If we cannot verify with your vet that you have shown consistent medical care for your pets, past or present, we will be unable to approve your application.

Are all of your current pets up-to-date on annual vaccinations, including rabies? Yes No

Are all of your current pets spayed or neutered? Yes No

Have all of your dogs been on regular heartworm preventative? Yes No

What type of heartworm preventative do you use?

Where do you or where will you purchase your heartworm medication?

Will your veterinarian have records to show you've made purchases of heartworm preventative? Yes No

ABOUT YOUR HOUSEHOLD

Number of Adults:

Number of Children:

Ages of the children:

Do all of the adults in the home know you are planning to adopt a GSP? Yes No *

Do any household members have animal allergies or suffer from Asthma? Yes No *

If yes, please explain:

Why do you want to adopt a dog (please check all that apply)? House Pet Companion for Child Companion for Pet Protection Gift Hunting Other

If other, describe:

LIFE OF YOUR NEWLY ADOPTED DOG

When do you want to adopt and bring a dog home? *

Which dog(s) are you interested in adopting? *

What are you looking for in a dog? (personality traits, age, sex, markings, docked/natural tail, etc) *

What will a day in your dog's life be like? *

Who will be the primary caretaker of the dog? *

GSPs are known for their high-energy level. Please describe in detail what sort of exercise you will provide for your GSP, as well as how often that exercise will be provided. *

How much time will the dog spend outdoors each day? *

Where will the dog sleep? *

Where will the dog be when nobody is home? *

Does your dog need to get along with other dogs? Yes No *

Are you willing to housetrain an adopted dog? Yes No *

For what reason(s) would you feel compelled to give up your GSP? Animal Aggression People Aggression Medical Expenses Housetraining Problems Children No Longer Home New Baby Fence Jumper/Escapes Yard Destructive in Yard/Home Won't Hunt Not Enough Time None Other *

If Other, please describe:

Please tell us a little about your home life: *

Are you willing to do obedience training if recommended? Yes No *

Are you wiling to buy and use a crate if recommended? Yes No

If No, why not?

Will you authorize a visit to your home by one of our volunteers before or after adopting a pet? All family members must be present. Yes No *

If you are approved, you and any current dog, will be required to travel to meet and adopt the dog. Are you willing to travel for this purpose? Yes No *

Have you ever owned a GSP or English Pointer? Yes No *

Many rescued GSPs will not hunt. Would you return the dog if it won't hunt? Yes No I'm not interested in hunting *

Do you understand and acknowledge that it could take up to two months for your newly adopted dog to settle in at your home? Yes No *

How did you hear about GSPRNTX? Our Website Adoption Event Friend Volunteer Another Rescue Group Petfinder Craigslist Other *

Would you like to be added to the Volunteer email list in your area? Yes No *

Do you have any other comments that would help us in approving your application or have questions you would like us to answer?

Are you looking at other avenues for Adoption? Yes No

Where else are you looking?

ADOPTION FEE

Our minimum adoption donation varies depending on the dog, ranging from $150-$300. Any additional contribution will be greatly appreciated.

PLEASE MAKE SURE YOU HAVE ANSWERED ALL OF THE QUESTIONS COMPLETELY BEFORE HITTING THE SUBMIT BUTTON.

Please type the letters and numbers you see in the picture.