Name
     Address:
           City:
           State:
     Zip Code:
          Phone:
           Email:

Is the German Shepherd Dog you are interested in
listed on our Available for Adoption page?
If so, please place their name here:

 Your Employer

      Employer:
     How Long:
            Phone:

Please List Two Non-Relative References

             Name:
          Address:
             Phone:

              Name:
           Address:
              Phone:

Veterinarian Information

              Name:
           Address:
              Phone:

Please Check Your German Shepherd Dog Preference

Male     Female    Either

Color Preference

       Black/Tan
          Black/Silver
White
         Solid Black
Sable
               No Preference

Age Preference

    Under 1 Year
1 - 2 years
 2 - 4 years
     Over 4 years
        No Preference

Who is the German Shepherd Dog for?

Why have you chosen a German Shepherd Dog?

Are there other animals in the household?

Yes   No

If Yes, how many and what?

Are there any children in the household?

Yes   No

If Yes, how many?

Ages of children?

Where will your German Shepherd Dog live?

 Inside
       Outdoors
Both

Your current or previous pet, did you
have them on heartworm prevention?

Yes  No

What brand?

Tell us about your current pets or your previous pet.

Do you own or rent your home?

Own     Rent

How long have you lived at your current address?

Do you have a fenced yard?

Yes     No

In order to continue saving German Shepherd Dogs,
GSDR of San Antonio requests that you make a donation of
 at least $150.00 in order to help continue our efforts to
rescue, foster and provide adoption for these
wonderful dogs.

What is the amount you are comfortable with donating?

A volunteer from GSDR of San Antonio will be visiting your
 home to help you prepare for the arrival of your
 German Shepherd Dog.  What time would be preferable?

AM  PM  Weekday  Weekend

Would you mind telling us how you heard about GSDR
of San Antonio? Please be as specific as possible.
 This information helps us locate other
 great homes like yours.

Questions/Comments

Thank you very much for taking the time to fill out this form and
helping us find good homes for our German Shepherds Dogs.