First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

Email*

Home Phone*

Work Phone
x

Cell Phone*

Alt Email*

What is your Instagram name?

Please list your age*

What is your occupation? Please state also if full-time or part-time, retired or student.*

Secondary Applicant's Name

Secondary Applicant's Age and Relationship?

Age of children (if any). Please include visiting children and/or other children the dog may be interacting with*

How did you hear about us*

Name of dog you are interested in adopting*
Choose an animal: Adam bonded with Lilith (must be adopted with Lilith bonded with Adam and Lilith bonded with Adam) Adele Akira Ashley Autumn Baby Girl- Courtesy Listing Bailee Big Mike Blue Diamond Bree Breezy Brock Buddy Buzz Candie Casper-Courtesy Listing Cassandra Diamond Elcie Ellie Frosty Bear Gaga Gilbert Goliath Harvey Izzy Java Kitty- Courtesy Listing Ladie Lance Lilith bonded with Adam (must be adopted with Adam bonded with Lilith and Adam bonded with Lilith) Maddox-Courtesy Listing Madison Maeve-Courtesy Listing Magnolia Maisie-Courtesy Listing Marley Maureen Meena-Courtesy Listing Miss Priss-Courtesy Listing Miyake Morgan-Courtesy Listing Murphy Pinto Bean - Courtesy Listing Radish Rae Rae Rita Rocky Sawana Silver Tami Ursus Willa Willy Windy Wynonna Yeti Zane Zelda Zephyr Ziggy

What is your second choice for the dog you are interested in?
Choose an animal: Adam bonded with Lilith (must be adopted with Lilith bonded with Adam and Lilith bonded with Adam) Adele Akira Ashley Autumn Baby Girl- Courtesy Listing Bailee Big Mike Blue Diamond Bree Breezy Brock Buddy Buzz Candie Casper-Courtesy Listing Cassandra Diamond Elcie Ellie Frosty Bear Gaga Gilbert Goliath Harvey Izzy Java Kitty- Courtesy Listing Ladie Lance Lilith bonded with Adam (must be adopted with Adam bonded with Lilith and Adam bonded with Lilith) Maddox-Courtesy Listing Madison Maeve-Courtesy Listing Magnolia Maisie-Courtesy Listing Marley Maureen Meena-Courtesy Listing Miss Priss-Courtesy Listing Miyake Morgan-Courtesy Listing Murphy Pinto Bean - Courtesy Listing Radish Rae Rae Rita Rocky Sawana Silver Tami Ursus Willa Willy Windy Wynonna Yeti Zane Zelda Zephyr Ziggy

Do you have a Gender and/or age preference? If so, what is your preference?*

Do you own or rent your home?*
Choose one: Rent Own

What type of home do you live in?*
Choose one: Single Family Duplex Apartment Townhouse Condominium Mobile Home Military Housing

If you rent your home, what is your Landlord's name or Rental/Management Company:

If you rent, what is your Landlord's or Rental/Management Company's phone number? 

If you rent, have you received the approval of your Landlord or Rental/Management Company to have a large breed dog? 
Choose one: Yes No

What is your Veterinarian's name and phone number?*

What is your Veterinarian's Phone Number?*

Is your yard fenced? *
Choose one: Yes No

We require secure visible fencing. What is the type and height of the fence? Please list any variations of fence height or type of fencing, if any*

Do you currently have any pets in the past 5 years? Please list any current pets first. *
Choose one: Yes No

Please choose the type of your 1st pet
Choose one: Dog Cat Bird Rabbit Other

Please tell us your 1st pet's NAME, BREED, AGE, and GENDER

Is this pet spayed or neutered?
Choose one: Yes No

Where did you get this pet?*

Do you still have this pet? If not, what happened to this pet?*

Please choose the type of your 2nd pet.
Choose one: Dog Cat Bird Rabbit Other

Please tell us your 2nd pet's NAME, BREED, AGE, and GENDER

Is this pet spayed or neutered?
Choose one: Yes No

Where did you get this pet?

Do you still have this pet? If not, what happened to it?

Please choose the type of your 3rd pet.
Choose one: Dog Cat Bird Rabbit Other

Please tell us your 3rd pet's NAME, BREED, AGE, and GENDER

Is this pet spayed or neutered?
Choose one: Yes No

Where did you get this pet?

Do you still have this pet? If not, what happened to it?

If you have other additional pets and/or farm animals, please list them here - and include their NAMES, BREEDS, AGES AND GENDERS.

If in the past 5 years, you currently have only small dog experience, do you have any large breed dog experience that you could give details about? *

If it has been longer than 5 years since you have owned a dog, but you DO have dog experience, please give details on what this experience was and list breed.*

Have you ever given up a pet? If yes, please explain:*

If you are applying to adopt a puppy 13 months old or younger please explain your philosophy on whose responsibility is it to make sure the puppy does not grow up to be aggressive?*

If you are approved to adopt a puppy 13 months old or younger would you return the puppy to GPRS if the puppy became aggressive as an adult? *
Choose one: Yes No Not Applicable

Please explain your knowledge of socialization, dog behavior and proper integration and rearing of a puppy or a rescued adult.*

What is your definition or philosophy of disciplining and training your dog?*

What are your plans for socialization and exercise for your puppy or rescued dog? What activities do you have planned? If this will be an only dog, how do you plan to keep the dog socialized with other dogs?*

Have you attended obedience classes before? *
Choose one: Yes No

Have you crated your dog in the past? *
Choose one: Yes No

Please list any expectations you may have for the dog (ie: service dog? livestock guardian dog? family pet? combination of any of those?)*

Are you aware that Pyrenees have a tendency to bark and roam if not securely fenced? *
Choose one: Yes No

Are you willing to housebreak a dog? *
Choose one: Yes No

Will your dog be kept inside or outside? *
Choose one: Inside Only Outside Only Inside and Outside

Where will the dog sleep?*

Where will your dog be kept when you are at the home?*
Choose one: Inside Only Outside Only Inside and Outside

Where will your dog be kept when you are not at home?* *
Choose one: Inside Only Outside Only Inside and Outside

How much time will the dog spend alone during the day? *

What level of activity would best suit your family? Low/Medium/High? *
Choose one: Low Medium High

Would you consider a dog with special needs such as blindness, deafness, physical limitations, etc.? *

Please tell us if you have had experience with any of the following behaviors:

Counter Surfing*
Choose one: Yes No

Experience with housetraining accidents*
Choose one: Yes No

Experience with leash pulling?*
Choose one: Yes No

Experience with inappropriate chewing*
Choose one: Yes No

Experience with barking*
Choose one: Yes No

Experience with fence jumping*
Choose one: Yes No

Experience with chasing cats or other smaller pets*
Choose one: Yes No

Experience with separation anxiety (whining, destructiveness or acting out when left alone)*
Choose one: Yes No

Experience with shyness toward strangers*
Choose one: Yes No

Experience with aggression toward other dogs*
Choose one: Yes No

Experience with resource guarding *
Choose one: Yes No

What characteristics do you find most appealing about a new dog? Mark all that apply

What other characteristics are you wanting to have in your dog?* 

What characteristics would you find the least appealing in a new dog? Mark all that apply 

Have you applied with other rescues? *
Choose one: Yes No

Please add anything that you think we should know here:

By submission of this application I attest that the information provided on this application is true and accurate to the best of my knowledge. I understand that completion and submission of this application does not guarantee adoption of a dog from the Great Pyrenees Rescue Society (GPRS). I hereby permit Great Pyrenees Rescue Society (GPRS) to contact my Veterinarian(s) and Landlord, if applicable. Please contact your vet as soon as possible to give them your permission for the vet's office to discuss your vet records with our rescue. We will be sending email to the email address listed on this application. Please check your spam filter in case it gets misdirected. Please initial here: * *