Adoption Form

Name or number of the dog you are interested in adopting:

Name

First

Last

Email

Street Address

City

State

Zip Code

Homeownership / Rental Details (select one)

Please list all adults living in home with ages. (including yourself)

omission the that

Please list all children living in home with ages.

Please describe any pet currently in your home.

How many hours a day will the dog you are applying for be left home alone?

Where will the dog be kept when you aren't home?

Where will the dog sleep at night?

Describe your yard and its fencing:

The dog you are adopting may need to be provided structure & training. What behaviors are you willing to work with? (select all that apply)

In the event of an emergency, how much are you willing to spend on vet bills ($)?

Adoptions are only considered for those individuals that are at least 18 years of age.

I am 18+
I am not 18

If selected, I agree to keep the dog safe, healthy, and secure at all times.

I agree to keeping the dog safe, healthy, and secure at all times.
I do not agree, dogs will be dogs

I am aware of the $250.00 adoption fee and able to pay that fee without causing a financial hardship to my home.

I am aware, it WILL NOT cause a hardship.
I am aware, it WILL cause a hardship.

I have read the above information carefully and have filled out this application honestly. I understand that omission of information and/or failure to answer all questions can result in this application being declined. Also, if an omission or untruth is discovered after an adoption takes place, I understand that the USGSD Society reserves the right to annul the adoption and reclaim the animal. By electronically checking below, I agree to the above.

I agree
I do not agree