YOUR INFORMATION

Name:

Co-Applicant Name:

Email Address:

(Please make certain you have entered your email correctly.)

Home Phone: Cellular Phone:

Address:
City: State: Zip Code:

Where are you employed?

Work Phone:

ABOUT YOUR RESIDENCE

Do you have a fenced in yard? Yes No

What type of fence do you have?

How tall is your fence?

Do you own or rent your residence? CHOOSE ONE Own Rent/ Lease If you rent, please fax your lease agreement or written authorization to have a dog from your landlord to
720-293-5026.

You live in a: CHOOSE ONE House Duplex Apartment Condo Townhouse Mobile Home Other If other, please specify:

How long have you been at this residence? CHOOSE ONE Less than 1 year 1-3 years More than 3 years

If you rent, does your landlord/management allow pets? CHOOSE ONE Yes No Unsure N/A

Please note any limits on the number/size of pets allowed:

PERSONAL REFERENCES

Name: Phone:

Name: Phone:

VETERINARY REFERENCE

Please provide us with the vet that has the most up-to-date records for your pets! If you do not currently own a pet but have in the past, please list the vet that provided care for your previous pet(s). Many vets maintain records for several years after a pet has passed away. By providing the following information, you grant us permission to contact your vet for a reference check.

Clinic Name:

Address:
City: State: Zip Code:

Phone: (PLEASE be sure to include phone number.)

INFORMATION ABOUT YOUR CURRENT AND PAST PETS

Do not list any pets you had as a child or while living with your parents. Please remember, we must be able to verify all information by calling your veterinarian.

I am a FIRST TIME pet owner. (Please skip to About Your Household).

CURRENT PETS

1. Name & Breed
Sex CHOOSE ONE Female- Spayed Male- Neutered Female- NOT Spayed Male- NOT Neutered Age
Kept Where

2. Name & Breed
Sex CHOOSE ONE Female- Spayed Male- Neutered Female- NOT Spayed Male- NOT Neutered Age
Kept Where

3. Name & Breed
Sex CHOOSE ONE Female- Spayed Male- Neutered Female- NOT Spayed Male- NOT Neutered Age
Kept Where

List ANY other pets currently in your home in the comments section at the end of this application.

PAST PETS

Include all pets owned in the past 10 years, other than those listed above. If you need more space, please continue in the comments section.

1. Name & Breed
Sex CHOOSE ONE Female- Spayed Male- Neutered Female- NOT Spayed Male- NOT Neutered Time Owned
Kept Where
What happened to this pet?

2. Name & Breed
Sex CHOOSE ONE Female- Spayed Male- Neutered Female- NOT Spayed Male- NOT Neutered Time Owned
Kept Where
What happened to this pet?

3. Name & Breed
Sex CHOOSE ONE Female- Spayed Male- Neutered Female- NOT Spayed Male- NOT Neutered Time Owned
Kept Where
What happened to this pet?

If we cannot verify with your vet that you have shown consistent medical care for your pets, past or present, we will be unable to approve your application.

Are all of your current pets up-to-date on annual vaccinations, including rabies? Yes No
Are all of your current pets spayed or neutered? Yes No
Have all dogs been on regular heatworm preventative? Yes No
What type of heartworm preventative do you use?
Where do you or will you purchase your heartworm preventative?
Will your veterinarian have records to show you've made purchases of heartworm preventative? Yes No

Many families that do not kennel their dogs on a regular basis do not give their dogs the Bordetella vaccine. This is NOT one of the vaccines we require during the veterinary reference check. However, since some of our dogs come from a shelter setting, we highly recommend that your pets be given this vaccine prior to a new dog joining your family.

ABOUT YOUR HOUSEHOLD

Number of Adults: Number of Children:

Ages of the children:

Do all the adults in the home know you are planning to adopt a GSP? Yes No

Do any household members have allergies to animals or asthma? Yes No
If yes, please explain:

Why do you want to adopt a dog (please check all that apply)? House Pet
Companion for Child Companion for Other Pet Protection Gift
Hunting Other
If other, describe:

LIFE OF YOUR NEWLY ADOPTED DOG

Which dog(s) are you interested in adopting?

What are you looking for in a dog? (personality traits, age, sex, markings, docked/natural tail, etc)

What will a day in your dog's life be like?

How much time do you expect to spend exercising your dog each day? (There is NO wrong answer!) CHOOSE ONE 15 minutes per day 30 minutes per day 1 hour or more per day

Who will be the primary caretaker of the dog?

Who will exercise the dog and what type of exercise?

How much time will the dog spend outdoors each day?

Where will the dog sleep?

Where will the dog be when nobody is home?

Does your dog need to get along with other dogs? Yes No

Are you willing to housetrain an adopted dog? Yes No

For what reason(s) would you feel compelled to give up your GSP?
Animal Aggression People Aggression Medical Expenses
Housetraining Problems Children No Longer Home New Baby
Fence Jumper/Escapes Yard Destructive in Yard/Home Won't Hunt
Not Enough Time None Other, please describe:

Please tell us a little about your home life. (Example: Are you social and active, enjoy staying home, work from home, stay at home parent or spouse, etc.):

Are you willing to do obedience training if recommended? Yes No
Are you willing to buy and use a crate if recommended? Yes No
If no, why not?

Will you authorize a visit to your home by one of our volunteers before or after adopting a pet? Yes No

Have you ever owned a GSP or English Pointer? Yes No
Are you aware of the temperaments, activity level and needs of these breeds?
Yes No
Many rescued GSPs will not hunt. Would you return a GSP that would not hunt?
Yes No I'm not interested in hunting

Do you understand and acknowledge that it could take up to two months for your newly adopted dog to settle in at your home? Yes No

How did you hear about GSPRNTX? Our Website Adoption Event Friend Volunteer Another Rescue Group Petfinder Craigslist Other

Do you have any other comments that would help us in approving your application or have questions you would like us to answer?

ADOPTION FEE

Our minimum adoption donation varies depending on the dog, ranging from $150-$250. Any additional contribution will be greatly appreciated.

PLEASE MAKE SURE YOU HAVE ANSWERED ALL OF THE QUESTIONS COMPLETELY BEFORE HITTING THE SUBMIT BUTTON.