Full Name: Address: City: State/Province: Zip Code: E-mail: Home Telephone #: Cell Phone #: Occupation: Whom are you employed with: Years Employed: Marital Status:
Single Married Divorced Spouse/Significant Other: Children in the home or visit often:
Yes No Name(s) of Children Age(s) of children: Relationship(s): Other adults in the home:
No Yes If yes, please list: Name, Age, Relationship: Do you own or rent your home?
Rent/Lease: Own: If you rent/lease, do you have permission from your
landlord to own a German Shepherd Dog?
Yes No Haven't Discussed This Yet If you rent/lease please give us landlord
info (name/phone): Type of home?
Single Family Home Apartment Condo Duplex Other How long have you lived at this residence? Any plans of moving? No Yes Please describe the current size of your yard? Is it fenced in?
Yes No Please describe your fence (type,construction, height,
etc.) If you don't have a fence, where will
the dog be excercised and be allowed to eliminate? Please list all pets that you currently
have(Include sex/age/species): Where would the puppy/dog live? If your puppy/dog will live outdoors please
explain in full detail about setup (containment, shelter, etc.) Do you fully understand the
commitment and responsibility of raising a GSD pup? Yes No Are you willing to crate train the puppy until they
are housebroken?
Yes No Un-Sure Uneducated, will need help Who will have the responsibility of the
dog/puppy? (Feeding, exercise, training, grooming, etc.)? Please explain any/all activities or hobbies
you and your family participate in? When you go away on business or vacation, where will
your dog go or who will care for it?
Pet Sitter Boarding Kennel Friends & Family - Remaining
at home Stay
with friends or family at their place Travel with us Other How will your dog travel to vet or other places? (Car/Van/Truck/etc.)
Please give details: Will there be anyone home regularly during the day?
Yes No Varies If 'Yes' or 'Varies', please explain
and give an approximate amount of hours per day? Have you ever owned a dog?
Yes No Have you ever owned a German Shepherd Dog?
Yes No Please list breeds of dogs, when you owned
them and if you no longer have them, what happened to them? Please explain why you want a German Shepherd: What type of canine training experience do you have?
None Basic Advanced Do you have a trainer that you currently
use or have used in the past? (If so, please list) What is your purpose for getting a GSD?
Family Companion Working (Police/Service/etc.) Breeding Personal Protection Sport (SchH, AKC, etc.) Show/Confirmation What is your timeframe for getting a GSD?
As soon as possible 1-2 months from now 3-4 months from now Sex Preference:
Male Female Not Sure Either Do you plan to spay/neuter?
Yes No Undecided What activites will you and your GSD be involved with
(Please pick your main goal)?
Puppy Classes Therapy Service Dog Police Work Agility Confirmation Schutzhund Personal Protection Obedience Search & Rescue If your goals include Show, Schutzhund,
Personal Protection, Agility, Obedience or any other sport where you can achieve titles. Please give us details: Have you
ever titled or trained dogs in these titles? Tell us about your achievements. If you have not please, give us your expectations
and goals for the future of this puppy/dog. If you are looking for a family companion
please tell us in detail what your expectations and goals are for this pup/dog: Please supply us names and telephone numbers
of (2) personal references (not related), preferably individuals who are familiar with your care of animals. You should have
known these people for at least two (2) years: Supply us with current or expected veterinarian
information (Name/location/Phone Number): Please give us any additional information
about yourself that will help us determine the best match with you and your family. Also tell us why you feel you could provide
a good home for one of our German Shepherds.
