Seattle Purebred Dog RescueSeattle Purebred Dog Rescue
Please fill out this form completely and return with $5.00 non-refundable listing fee to the address on the back. SPDR is a non profit referral service. The listing fee goes to cover our operating costs. If we are successful in placing your dog, we would appreciate an additional, tax deductible donation to our organization.
Owner's name ___________________________ home phone (_____)__________________________
Address__________________________________ work phone (_____)_________________________
City _________________________ State _______ Zip _________ e-mail ______________________
Best time to call: ____________________________________________________________________
Dogís breed______________________ Age ________ Birth date _____________________________
Dogís registered name: ______________________ dogís call name____________________________
Are AKC papers available? ________ Will you provide these to new owner? ___________
Is dog co-owned? __________ (If yes- provide signed release from co-owner)
Color ________ Weight _________ Sex ___________ Spayed/Neutered? ________
Housebroken? _________ Crate trained? ________ Paper trained? _________
How long have you owned this dog? ____________________________________________________
Was dog bought from breeder? (If yes give name)__________________________________________
Have you notified breeder about need to find dog new home? _________________________________
What was breederís response? __________________________________________________________
Was dog bought from pet store? (If yes give name & location)_________________________________
Was dog bought from shelter? (If yes give name & location)__________________________________
Did shelter request that dog be returned to them? ___________________________________________
If not bought from breeder, shelter or pet store how did you get dog? ___________________________
Dogís veterinary of record? ____________________________________________________________
Are shots up to date? _______ Will you provide health records to new owner? ________
(If applicable) Is tail docked? __________ Are ears cropped ___________
Does dog have any physical problems? ___________________________________________________
Allergies? _____________________ On medication? _______________________________________
If unspayed female, when was last heat cycle? _____________________________________________
If unspayed female, is there any chance dog may be pregnant? ________________________________
Has dog had any obedience classes? ____________ Where? __________________________________
Any other training? _________ guard * agility * herding * tracking * hunting * other
Who was dogís trainer? _______________________________________________________________
List commands, tricks, and skills: _______________________________________________________
What brand food does dog eat? __________How much does dog eat daily? ______________________
Dog has spent days (Circle all that apply): Indoors/ Crated/ Basement/ Garage/
Fenced yard/ Loose unfenced/ Tied out/ Kennel run/ Other:
Dog has spent nights (Circle all that apply): Indoors/ Crated/ Basement/ Garage/
Fenced yard/ Loose unfenced/ Tied out/ Kennel run/ Other:
How does dog react to:
Other dogs? _________________ Cats? _________________ Strangers? ______________
Children? ___________________ Walking on lead? ___________
Alone in yard? ________________ Alone in house? ___________________
Alone in car? __________________
Does dog have the following habits?
Excessive barking? _________ Digging? ______________ Jumps fence? ___________
Destructive chewing? ____________ Aggressive? ____________ Shy? ___________
Does dog fight with other dogs? _____________
Has dog killed/chased other animals? (If yes, describe)_______________________________________
Has dog ever bitten a person? (If yes, describe)_____________________________________________
Did wound require medical attention? ___________________________________________________
Was bite reported to city or county animal control? _________________________________________
Was dog quarantined? ______ What brought on this bite? ____________________________________
Does dog growl when you take away itís food or toys? ______________________________________
Does dog snap or nip at people? _______ What causes this behavior? __________________________
What does dog like best? _________________ dislike?_________________ fear?________________
Why is dog up for adoption?___________________________________________________________
__________________________________________________________________________________
Have you tried to place this dog yourself (describe)_________________________________________
What is the most appealing thing about this dog? ___________________________________________
What is its biggest fault? ______________________________________________________________
Do you understand that all dogs placed by SPDR must be spayed or neutered as terms of adoption? ________
Do you understand that we may not be able to place this dog due to its age, health, physical condition, personality, lack of training, or lack of demand for its breed? _______
How did you hear about SPDR? ________________________________________________________
May we give your phone number to approved applicants who may be interested in your dog? ________ Best time to call ___________________________________________________
If you have a good photo of the dog, please include with application.
Please read the following carefully, sign and date.
I, ____________________________________________, hereby make available for adoption through Seattle Purebred Dog Rescue this (breed)_______________________ named ___________________. I certify that I am the owner of this dog, free and clear of all other interests. I certify that this dog is not possessed of any dangerous or vicious propensities and that I have not willfully concealed information about this dog that might indicate such propensities. The information I have provided about this dog is true and complete. I hereby forever release, discharge and agree to hold harmless and indemnify Seattle Purebred Dog Rescue, its board of directors, officers, members and agents from all claims, demands, actions, causes of action, or liability of any kind whatsoever arising as a result of or in connection with the adoption or other disposition of the above named dog.
Read, understood and agreed:
____________________________________________________ ____________________________
Owner's signature Date
Return completed form with $5.00, nonrefundable listing fee to:
Seattle Purebred Dog Rescue