First Name*
Last Name*
Address*
City*
State/Province*
Zip/Postal Code* -
Email*
Home Phone
Work Phone x
Cell Phone
Please list your age:*
Secondary Applicant's Name:
Age of children (if any)? Please include visiting children and/or other children the dog may be interacting with:*
How did you hear about us?
What is your occupation? Please state also if full-time or part-time, retired or student.*
Do you own or rent your home?* Choose one: Rent Own
In what type of home do you live?* Choose one: Single Family Duplex Apartment Townhouse Condominium Mobile Home Military Housing
If rent, Landlord's name:
If rent, Landlord's phone #
If you rent, have you received the approval of your landlord to have a large breed dog?
Is your yard fenced?
What is the type and height of the fence? We require secure visible fencing.*
Veterinarian's Name:*
Veterinarian's Phone Number:*
Do you currently have or have you had any pets in the past 5 years?
Please give us information on each animal separately.
Please enter your first pet's name, breed, age and gender:
Is this pet spayed or neutered?
Where did you get this pet?
Do you still have this pet? If not, what happened to it?
Please enter your second pet's name, breed, age and gender
Please enter your third pet's name, breed, age and gender:
Please enter the information requested above for any other pets/livestock that the new dog would be around
Have you ever given up a pet? If yes, please explain:*
Have you crated your dog in the past?
Have you attended obedience classes before?
What is your definition or philosophy of disciplining and training your dog?*
Please tell us if you have had experience with any of the following behaviors:
Experience with counter surfing?
Experience with housetraining accidents?
Experience with leash pulling?
Experience with inappropriate chewing?
Experience with barking?
Experience with fence jumping?
Experience with chasing cats?
Experience with separation anxiety (whining, destructiveness or acting out when left alone.)
Experience with shyness toward strangers?
Experience with aggression toward other dogs?
Experience with resource guarding?
What are your plans for socialization and exercise of the dog?
What 3 characteristics do you find most appealing about a new dog? Choose 3
Other:
What characteristics would you find the least appealing in a new dog? Mark all that apply
Which characteristics might cause you to want to return an adopted dog. Explain each in detail.
Other:*
Explain:*
Name of animal you wish to adopt: Choose an animal: Angel Anna Daisy Mae Hercules K5 (Koda) U Kenai Kewpie Mocha Pyper Spud
List your second choice: Choose an animal: Angel Anna Daisy Mae Hercules K5 (Koda) U Kenai Kewpie Mocha Pyper Spud
Please give your choice if unlisted:
Would you consider a dog with special needs such as blindness, deafness, physical limitations, etc.?
Gender and age preference:
Please list any expectations you may have for the dog (ie: service dog? livestock guardian dog? family pet? combination of any of those?)* *
What level of activity would best suit your family? Low/Medium/High?
Are you willing to housebreak a dog?
Will the animal be kept inside or outside?* Choose one: Inside Only Outside Only Inside and Outside
Where will the animal be kept when you are not home?*
Where will the animal be kept when you are home?*
Where will the animal sleep?*
How much time will the animal spend alone during the day?*
Have you applied with any other rescue?
If yes, please give name(s) of other rescue organization
Are you aware that Pyrenees have a tendency to bark and roam if not securely fenced?
Do you want to foster or adopt?
By submission of this application I attest that the information provided on this application is true and accurate to the best of my knowledge. I understand that completion and submission of this application does not guarantee adoption of a dog from the Great Pyrenees Rescue Montana. I hereby permit Great Pyrenees Rescue Montana to contact my Veterinarian(s) and Landlord, if applicable. Please contact your vet as soon as possible to give them your permission for the vet's office to discuss your vet records with our rescue. We will be sending email to the email address listed on this application. Please check your spam filter in case it gets misdirected. Please initial * *
Comments:
