German Shepherd Rescue of Northern California

Version May 9, 2020

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:*

Who will be responsible for the dog’s care?
Check all that apply and indicate which person will have primary responsibility.

Primary	Adult	Name:
Primary	Adult	Name:
Primary	Child	Name:	Age:
Primary	Child	Name:	Age:
Comments: (max 500 characters including spaces)

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

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

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

Please tell us about your current pets and animals, including any livestock.

Species:	Breed:	Gender:	Age:
Primary Living Area:	Spayed/Neutered? Yes No	Where does this animal sleep? Inside Outside
Comments:
(max 200 characters including spaces )

Species:	Breed:	Gender:	Age:
Primary Living Area:	Spayed/Neutered? Yes No	Where does this animal sleep? Inside Outside
Comments:
(max 200 characters including spaces)

Species:	Breed:	Gender:	Age:
Primary Living Area:	Spayed/Neutered? Yes No	Where does this animal sleep? Inside Outside
Comments:
(max 200 characters including spaces)

Species:	Breed:	Gender:	Age:
Primary Living Area:	Spayed/Neutered? Yes No	Where does this animal sleep? Inside Outside
Comments:
(max 200 characters including spaces)

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)

Do you own or rent your home?
Own Rent – Please Note: a written landlord agreement will be required.

Which best describes your residence?
House Condo/Townhouse Apartment Farm or Ranch

Please describe fencing in the yard or exercise area where your dog will be outside:
Fenced yard Partially fenced yard Fenced yard area for dog
No fence "Invisible" fence Enclosed dog kennel/run
No yard

Indicate height of your fence at its lowest point:
4' or less 5' 6' or higher No fence

Do you have a swimming pool?
No
Yes - it’s not fenced
Yes - It is fenced off from the rest of the yard

10.

Please tell us about your personal experience with dogs:
Never had a dog
Never had a dog as an adult, but grew up with them
Have spent a lot of time with dogs owned by others
Have spent a lot of time with German Shepherds owned by others
Have (had) family dog(s) that were not German Shepherds
Have (had) a German Shepherd) a German Shepherd
Have (had) several German Shepherds

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
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?
Rarely
2-4 hours
4-7 hours
7-10 hours
More than 10 hours

16.

Where do you want your dog to spend its time?
Inside full time, outside rarely
Inside most of the time with access to outside, sleeps inside
Inside when you're home, outside when you're gone
Mostly outside in yard, rarely in house, sleeps in garage or dog house
Outside only

17.

What type of dog would you prefer?
Gender: Male Female No Preference

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?
Yes, I'd like to learn more
No thanks

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

Adoption Fees can be found on our homepage in the "Available Dogs" drop down menu or by clicking here. The adoption fee is based on the age of the dog.

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!

Adoption Questionnaire