GREAT PYRENEES RESCUE ADOPTION APPLICATION

Adopted Great Pyrenees must be an indoor/outdoor dog.  Adopted Great Pyrenees must have a fenced yard.
Adoption fee of $200 includes vet check, vaccinations, spay/neuter, fecal check, heartworm check, flea and tick treatments, and grooming.

* - indicates a required entry
Personal Contact Info
First Name:
Last Name:		 *
Street Address *
City *
State *
Zip *
Daytime phone:
Evening phone:		 *
E-mail address *
Date of Birth
Family Info
Please list adults in household (max 255 characters)
Please list children in home and ages (max 255 characters)
Does any member of your household have allergies? (max 255 characters)
Pet History
List the animals you currently own or have owned in the past 3 years. Please include the breed, age, and what happened to him/her. (max 255 characters)
Spayed/Neutered: 
Spayed/Neutered: 
Spayed/Neutered: 
Spayed/Neutered: 
Are your current pets on Heartworm preventative?
Have your pets ever been taken to animal control?
If so why, and did you redeem it? (max 255 characters)
List your veterinarian, address and phone number (max 255 characters)
Desired Pet Info
Why do you want a Pyr? (max 255 characters)
Prefered Sex
Age Range
Do you want a Livestock Guardian Dog (LGD)?
Home Info
Where will the dog be during the day?
Where will the dog be during the night?
Do you have a fenced yard?
If yes, describe type and height (max 255 characters)
How many hours each day will the dog be alone?
May we do a home visit?
Do you live in a House, Apartment, Condo or Mobile home?
Do you own or rent?
If renting, provide name and phone # of landlord (max 255 characters)

By electronic submission of this application I certify that the information I have provided is true and accurate.

Page last updated 2 January 2006 11:46AM