NCSBGRR - application form

Thank you for your time and interest in our special orphaned saints.
We will be back in touch after we review your application.

Please contact us if you do not receive a notification within 72 hours.

Please review our Adoption Contract before you fill out this application.
For questions or comments about the NCSBGRR application please send an email.
Please note our adoption area is within 6 hours drive of Spring Lake, NC.
Personal Information

First Name: *
Last Name : *
Your e-mail address: *
Telephone : *
Cellphone :
Mailing Address:
Street Address :
City:
State:
Zip:

Occupation:

Spouse/Significant Other First Name:
Spouse/Significant Other Last Name :
Spouse Occupation:

Number of persons in household:
Adults:
children:
ages of children:

List at least 1 Personal Reference (Name and Telephone Number)


Home Information
Which best describes your home:
If Other, please describe:

Is your home rented?	No Yes
If rented please list your landlord and contact information (phone / address)


Do you have a fenced yard?	No Yes
If Yes, what type of fencing do you have?
Height of fencing?
Length of fencing?
Width of fencing?

Pet Information Please list all veterinarians used and all pets owned in the last 4 years.
Primary Veterinarian Reference(s)
Veterinarian Name:
Veterinarian Hospital Name:
Telephone :
Address:
City:
State:
Zip:
Name and telephone number for all other veterinians used in the last 4 years


List all pets owned in the last 4 years
Total number of pets * owned in the last 4 years:
Pet 1
Breed :	Sex: Male Female
Name :	Age : year(s)
How long has (or did) this pet live with you? : years.
Where is the pet now :	Spayed or Neutered? Yes No
Up to date on all shots? : Yes No	On monthly heartworm preventive? Yes No
Pet 2
Breed :	Sex: Male Female
Name :	Age : year(s)
How long has (or did) this pet live with you? : years.
Where is the pet now :	Spayed or Neutered? Yes No
Up to date on all shots? : Yes No	On monthly heartworm preventive? Yes No
Pet 3
Breed :	Sex: Male Female
Name :	Age : year(s)
How long has (or did) this pet live with you? : years.
Where is the pet now :	Spayed or Neutered? Yes No
Up to date on all shots? : Yes No	On monthly heartworm preventive? Yes No
Pet 4
Breed :	Sex: Male Female
Name :	Age : year(s)
How long has (or did) this pet live with you? : years.
Where is the pet now :	Spayed or Neutered? Yes No
Up to date on all shots? : Yes No	On monthly heartworm preventive? Yes No
Pet 5
Breed :	Sex: Male Female
Name :	Age : year(s)
How long has (or did) this pet live with you? : years.
Where is the pet now :	Spayed or Neutered? Yes No
Up to date on all shots? : Yes No	On monthly heartworm preventive? Yes No

If more than 5 please list the same information for the others:


How and where do you exercise your pets?

How many hours would the dog be alone on a typical day?
Where will you keep the dog during the day?
At night?

Why are you looking for a saint bernard? Protection Breeding Purposes The Kids A Companion	(check all that apply) A Gift Guard Dog Obedience Work Other

Are you prepared to give your adoptive saint at least a month to acclimate to the new home? : Yes No
Have you ever given a pet away or re-homed a pet? If so, how and why?


Please list any dog(s) or type of dog(s) you are interested in (sex, age range, personality, etc)

Who will care for your pet(s) if you are away for any reason - vacation, emergency, other?

Is there anything else you would like for us to know?

Items marked with an '' are required, the form will not submit without answering these items.*
Thank you for your time and interest in our special orphaned saints. We will be back in touch after we review your application. Please contact us if you do not receive a notification within 72 hours.

or

Personal Information

Home Information

Pet Information

Please list all veterinarians used and all pets owned in the last 4 years.

List all pets owned in the last 4 years