Adoption Name(Required) First Last Address(Required) Street Address City AlabamaAlaskaAmerican 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(Required)Mobile PhoneWork PhoneBest time to callEmail(Required) Occupation(Required) About the dog you want to adopt Each 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. You may select up to three breeds 1st Choice Breed(Required) 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 TerrierXoloitzcuintleThis field is hidden when viewing the formBreed rep 1Interested in a 2nd breed? Optional No Yes Optional: 2nd Choice Breed 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 TerrierXoloitzcuintleThis field is hidden when viewing the formBreed rep 2Interested in a 3rd breed? Optional No Yes Optional: 3rd Choice Breed 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 TerrierXoloitzcuintleThis field is hidden when viewing the formBreed rep 3Are you interested in a specific individual dog you’ve seen listed?I will also consider a suitable dog of a different: Sex Color Age size Sex preferred Male Female Either Would you consider a dog that required special attention? Diet Medications Extra Training Physical disability Acceptable age range Any age Puppy Adult Senior Color PreferredSize PreferredCoat length/type PreferredIndicate all plans for this dog(Required) Pet Guard Agility Obedience Hunting Other (describe) OtherHow do you plan to exercise your dog? How often?(Required)Where will this dog spend its day? Loose indoors Outdoor kennel Crate indoors Basement Garage Fenced yard Tied up outside Other (describe) OtherWhere will this dog spend the night? Loose indoors Outdoor kennel Crate indoors Basement Garage Fenced yard Tied up outside Other (describe) OtherWhere will you keep the dog when no one is home?(Required)Where will you keep the dog when you are home?(Required)How many hours each day, on average, will this dog will be left alone without people present?(Required)How often do you feed your dog and where?(Required)What do you plan to feed your dog?(Required)What is the plan for this dog if you must leave town(Required)What is the plan for this dog if you move(Required)What is the plan for this dog if you can no longer care for it(Required)Have you ever sold, given away, or surrendered a dog in the past?(Required)What would you say are the"pros" about this breed?What would you say are the"cons" about this breed? About You Why did you choose the above breed(s)Have you owned the above breed(s) beforeWhat experience do you have with dogs? Pet Training Showing Breeding Other (Describe) DescribeAre you prepared to begin and or continue a positive reinforcement training?(Required)How many dogs have you owned in the last 7 years? Describe them below. (Click the + sign to add more)BreedHow long?Still own?If not, what happened to the dog(s) Add RemoveAny other dogs in the last 7 years? Provide the information hereDo you have a regular veterinarian Yes No If yes, vet's NameClinic NamePhone Number Add RemovePersonal References #1 (not a family Member)(Required)NamePhone NumberRelationshipHow long knownPersonal References #2 (not a family Member)(Required)NamePhone NumberRelationshipHow long knownDo you understand that SPDR requires all adopted dogs to be spayed or neutered?(Required) Yes No Do you agree to license your SPDR-adopted dog on an annual basis?(Required) Yes No Do you agree to provide reqular healthcare for your SPDR dog?(Required) Yes No Do you agree to contact SPDR if you can no longer keep this dog?(Required) Yes No About Your Home/Family Indicate your home type(Required) Home Apartment Mobile Home Other How long have you lived there?(Required)Do you own or rent? Rent Own If rentingLandlord's NameLandlord's PhoneDo you have your landlord's permission to own a dog? Yes No Do you have a fenced yard?(Required) Yes No If no, how will you handle the dog's exercise and toilet duties?What kind of fence do you have? Such as solid wood, Chain link, Farm Fence, Buried wire or Other (Describe)Fence TypeHeight Add RemoveDo you have a dog door to a secure fenced yard? Yes No Do you have an outdoor kennel run?(Required) Yes No Other Are there other dogs in the house?(Required) Yes No Dogs in the house. (Click + to add more).Dog nameSexBreedAgeSpayed/NeuteredCurrent on vaccinations? Add RemoveHow many other pets in your home and their types (cats, birds, rodents, etc)(Required)Will this dog have access to livestock? Cows, horses, chickens, rabbits, etc.(Required)Are there other adults in the house?(Required) Yes No List all adults in your householdAre there children in the house?(Required) Yes No List all children in your household with their agesAre there any other regular visitors to you home, human or animal, with which your new adopted dog must get along (describe)? If they are children, include their ages.Are any family members allergic to dogs (describe)?Do all family members want to adopt a dog? If no, explain Yes No Other Will you let an SPDR representative visit your home by appointment?(Required) Yes No. If no, explain ExplainHow did you hear about SPDR?Any additional comments? Agreement and Consent Please read our Terms of AdoptionI , (full name below), Hereby acknowledge the following policies and agree to abide by them. (Click each box).(Required)Policies(Required) All the information I have provided on this form is true and complete. I have read and agree with SPDR's Terms of Adoption. Should an unneutered/unspayed dog be placed with me, I agree to have it altered within one month of adoption, or by a date agreed upon by me and a representative of SPDR. This dog will reside in my home as a pet. I will provide it with adequate food, water, shelter, training, affection and medical care. I understand that SPDR is a referral service and is not responsible for the accuracy of information received about temperament, habits or physical condition of dogs available for adoption. I understand that it is my responsibility to see and evaluate the dog for myself before agreeing to adopt it. I am in full agreement with these stated terms of adoption. Seattle Purebred Dog Rescue is in no way liable or responsible for any damage, accident, or injury resulting from the placement of a dog into my household. SPDR, AT ITS SOLE DISCRETION, RESERVES THE RIGHT TO REFUSE ANY APPLICANT FOR ANY OR NO REASON Please review your application before clicking Submit PLEASE NOTE: You will receive an email copy of your application as a confirmation. If you do not receive it, please resubmit your application online or print and mail a copy.
