Listing "*" indicates required fields Name* First Last Address* Street Address City StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Home Phone*Mobile PhoneWork PhoneBest time to call Email* May we give you phone number(s) to approved applicants who are interested in your dog?* Yes No About the dog you want to listEach breed of dog has a different SPDR volunteer (Breed Representative) responsible for its rescue and placement. If a breed is not listed here, we currently do not have a representative for that breed.Breed to list* BasenjiBernese Mountain DogBorder TerrierBoston TerrierBull TerrierBulldogChow ChowCollieCurly-Coated RetrieverDachshundDoberman PinscherEnglish BulldogEnglish SetterFrench BulldogGerman Shorthaired PointerGerman Wirehaired PointerGordon SetterGreat DaneGreater Swiss Mountain DogIrish Red and White SetterIrish SetterJapanese ChinKeeshondKerry Blue TerrierLabrador RetrieverLhasa ApsoLlewellin SetterManchester TerrierMexican HairlessMiniature Bull TerrierMiniature SchnauzerNewfoundlandNorwegian ElkhoundOld English SheepdogPekingesePharaoh HoundPomeranianRhodesian RidgebackRottweilerSamoyedSchipperkeScottish TerrierSealyham TerrierShetland SheepdogShih TzuStandard SchnauzerTibetan SpanielWelsh TerrierWest Highland White TerrierXoloitzcuintleHiddenRepresenative_Email Dog's age Dog's Birthdate Dog's Registered Name Dog's Call Name Are registration papers available Yes From what registration organization. Below No Registration Organization Will you provide the registration papers to the new owner Yes No Is the dog microchipped Yes No Microchip ID Is the dog co-owned? If yes, you must provide a signed release from the dog's co-owner Yes No Dog's color Dog's weight Sex Male Female Spayed / Neutered Yes No Is the dog crate trained? Yes No Housebroken? Yes No Paper Trained? Yes No How long have you owned this dog? Are you the first owner of this dog Yes No Have you tried to re-home this dog yourself? (Describe)Was this dog bought from a breeder? Yes = Breeder's name below No Breeder's Name Did you ask the breeder about re-homing? Yes = Breeder's Response Below No Breeder's ResponseWas the dog bought from a pet store Yes = Name of store / city below No Name of pet store and city Was the dog adopted from a shelter Yes = Name of shelter / city No Name of shelter and city If not from a breeder, shelter, or pet store, where did you get this dog?Dog's veterinarian's name, city and phoneAre the dog's shots up to date? Yes No Will you provide health records to the new owners? Yes No (If applicable): Is the tail docked? Yes No (If applicable): Ears cropped? Yes No Dewclaws removed? Yes No Describe any physical problems the dog has:Any allergies? Yes No Is the dog on medication? Yes = List below No Medications(If unspayed female): Is there any chance she's pregnant? Yes = See Below No Last heat cycle Has the dog had any obedience classes? Yes - List below No Obedience classes Other training? Select all that apply CGC Guard Agility Herding Tracking Hunting Trainer List all commands, tricks, and skills:What brand of food is fed? How much food does the dog eat per day? Does the dog growl when you take away food or toys? Yes No What does the dog dislike?What does the dog like best?What does it fear?Does the dog have the following habits? Destructive Chewing Digging Jumps/Climbs Fence Excessing barking Where has this dog spent its days? Loose Indoors Crate Indoors Basement Garage Outdoor Kennel Fenced Yard Tied up outside Other - below Other Where has this dog spent its nights? Loose Indoors Crate Indoors Basement Garage Outdoor Kennel Fenced Yard Tied up outside Other - below Other Is the dog ... (check all that apply) Aggressive Alpha Confident Playful Reserved Timid/Shy Nervous Fearful How does the dog react to being alone in the home?How does the dog react to being alone in the yard?How does the dog react to being alone in the car?How does the dog react to strangers?How does the dog react when meeting other dogs?How does the dog react to being walked on a leash?Is this dog aggressive to other dogs? Yes No Sometimes Has it lived peaceable with other dogs? Yes No How does the dog react to cats?Has it lived peaceably with cats? Yes No How does the dog react to livestock?Has it lived around livestock? Yes No Does this dog chase other animals? Yes - Describe below No DescribeHas this dog killed another animal? Yes - Describe below No DescribeHow does this dog react to children?Has the dog lived with children? Yes - How many and what ages No Children: How many and what agesDoes this dog snap or nip at people? Yes - What causes this? Below No Cause for snap or nipHas this dog ever bitten a person? Yes - What causes this? Below No Bitten a personDid the wound require medical attention? Yes - Describe below No Describe medical attentionWas the bite reported to city or county animal control? Yes - In what city or county? Below No Bite reported to animal controlWas the dog quarantined? Yes - Describe below No DescribeWhat is the most appealing thing about this dog?What is this dog's biggest fault?Why is this dog up for adoption?How did you hear about SPDR?Agreement and ConsentI (retype full name) Hereby acknowledge to following polices and agree to abide to them. (Check each box below).* Please be sure to read our Terms of AdoptionI hereby make available for adoption through Seattle Purebred Dog Rescue this dog:. Enter dogs Name and Breed* 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 forever release, discharge and agree to hold harmless and indemnify Seattle Purebred Dog Rescue, its Board of Directors, officers and agreements 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 any other disposition of the above-named dog.SPDR Dog Listing Agreement* All the information I have provided on this form is true and complete. I understand that any intact (not spayed or neutered) dog placed by SPDR must be spayed or neutered as a term of adoption. I understand that any intact (not spayed or neutered) dog placed by SPDR must be spayed or neutered as a term of adoption. I understand that I may not receive compensation for my dog. I understand that SPDR may not be able to place this dog due to its age, health, physical condition, personality, lack of training, or lack of demand for this breed. Please review your application before clicking Submit
