White German Shepherd Rescue

PROSPECTIVE ADOPTER QUESTIONNAIRE
FOR WHITE GERMAN SHEPHERDS

Adoptions Limited to within the State of Arizona
 Please provide us with the following information so that we can better assist in finding the right dog for you and your family. Thank you!

PERSONAL INFORMATION:

Name: 

Email Address (REQUIRED in order for us to respond to your questionnaire submission;
     we will not call you): 

Phone Number (Home):    (Work):    Cell Phone: 

Home Address: 

City:    State:    Zip Code: 

Are you interested in fostering, fostering-to-adopt or adoption?:     Fostering     Fostering to Adopt     Adoption      Unanswered

Are you currently in the military/reserves?:     Yes     No      Unanswered

FAMILY INFORMATION:

How many people are in your family?:

How many adults?:

How many teenagers?:

How many elementary school age?:

How many under 5?:

What is the age range of the adult(s) in your family?:     20-34     35-49     50-64     65+

Are there other dogs currently residing in your household?:     Yes     No     Unanswered

If yes, please give breed, age and sex)    

If yes, are the other dogs spayed/neutered?:     Yes     No

Please describe your family (please check where appropriate and provide pertinent information (e.g., age) in the box to the right of each checkmark):

Children    

Toddlers (4 and under)    

Cats    

Small Dogs (please give breed, age and sex)    

Other pets in family (e.g., ferrets, snakes, guinea pigs, etc.)    

HOME INFORMATION:

Do you own or rent your home?:     Own     Rent     Unanswered

If you rent, do you have a letter from the owner of the property stating that you have their permission to have (not any--but specifically) a German Shepherd Dog on their property? (please refer to our policy page):  Yes     No          Not Applicable   Please Note: If you are a renter, we MUST see a rental permission letter OR a copy of your lease.)

What type of home do you have?:     One story     Two story     Condo      Apartment      Unanswered

Do you have a fenced yard? (Please note a MINIMUM 5' fence is required):     Yes     No      Unanswered

If yes, what type & height fencing do you have?:

If no, how do you plan to give your dog the appropriate exercise?:

Do you have a doggie door?:    Yes    No     Unanswered

Do you have a pool?:     Yes     No      Unanswered

If yes, will the dog be allowed to swim?:     Yes     No      Unanswered

If yes, is it fenced off from the house/yard?:     Yes     No      Unanswered

If the pool is not fenced off from the house/yard, how do you plan to keep the dog safe/away from the pool?:

DOG INFORMATION:

Will you consider a mixed breed?:     Yes     No     Possibly      Unanswered

Are you looking for a male or a female?:    Male     Female     Either     Unanswered

What age dog are you looking for?:

How many hours will the dog be left alone during a typical day?: 

EXACTLY where do you keep the dog when you are not home? (Please be specific, i.e., loose outside, outside in a kennel, indoors free, indoors in a crate, in the laundry room, etc.:

Will this dog be an indoor or an outside dog?:    Indoors     Outside

EXACTLY where will the dog sleep at night?:

Will you crate and/or crate train your new dog?:     Yes     No     Unanswered

Have you owned other dogs in the past?:    Yes     No     Unanswered

Have you owned/trained a German Shepherd in the past?:    Yes     No      Unanswered

Are you prepared to attend training classes with your adopted dog if that were a condition of his or her adoption?:     Yes     No     Unanswered

Will you walk your dog(s) often?:    Yes     No     Unanswered

If no, will your dog ever be taken off of his home property?:    Yes     No     Unanswered

If yes, please state where the dog will be allowed to go with you:

Will the dog be treated as a member of your family?:    Yes     No, it's just a dog

Why do you want to adopt a white German Shepherd?:

Are you and your family prepared to deal with the training and special issues (i.e., lack of training, unknown history, possible fear of abandonment) which normally come with adopting a rescue dog?:    Yes     No

Are you willing to travel to the north side of Phoenix to be introduced to dogs that are available for adoption and that we feel would be a good fit for your family?:    Yes     No

Which white German Shepherd on our site are you specifically interested in?:  (Please remember, this form is ONLY for the WHITE German Shepherds listed on our site. Introductions with other (colored) dogs cannot be arranged through submission of this form. If you are interested in meeting any of the colored shepherds on our site, please follow the directions on their bio pages. Thank you.)

What is the name, address and phone number of your veterinarian?  (You will be asked to have a veterinarian before a dog is placed into your home.):

Have you read "ADOPTION BEGINS HERE" on our website?:    Yes     No   (If you have not, please do so before contacting us on a specific dog.)

When you have finished filling out this form, please click "SUBMIT" to send your form to us. PLEASE DO NOT LEAVE ANY QUESTIONS UNANSWERED. We will be in touch with you VIA EMAIL once we have reviewed your form. If you do not receive an email response from us within 48 hours, please make sure you have provided your email address and/oremail Nancy at WhiteGSDRescue@aol.com