First Name*
Last Name*
Address
City
State/Province
Zip/Postal Code -
Email*
Home Phone
Work Phone x
Cell Phone
Alt Email
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: *
Relation to the second applicant: *
What is the second applicant's occupation? Full-time, part-time, retired?*
List ALL members' names & ages currently residing in the same household (including roommates if any):*
Who in the household will care for the pet*
List all visiting children and their ages (If any in the household or visiting the household):*
Please list any anticipated major changes in the next 6 months (new baby, relocation, additional new pets, job change...etc.)*
Does anyone in the home have special needs? Please describe.*
Do you want to foster or adopt?* Choose one: Adopt Foster
What is the name of the dog you are interested in?* Choose an animal: Daisy Mae Jesse Lily LizzyBeth Maccabbi (aka Mac) Moose Skye Unknown (intake Pending)
What is your second choice for the dog you are interested in?* Choose an animal: Daisy Mae Jesse Lily LizzyBeth Maccabbi (aka Mac) Moose Skye Unknown (intake Pending)
How did you hear about us*
Do you own or rent your home* Choose one: Rent Own
In what type of home do you live* Choose one: Single Family Duplex Apartment Townhouse Condominium Mobile Home Military Housing
How long have you been living in the current address?*
If you rent, please enter your landlord's name and phone number*
If you rent, have you received the approval of your landlord to have a large breed dog?* Choose one: Yes No
Veterinarian's Name and Phone Number*
Is your yard fenced* Choose one: No Yard Unfenced Yard Yard Partially Fenced Yard Completely Fenced
What is the height of the fence*
What type of fence* Choose one: Privacy Chain Link Invisible
Do you currently have or have you had any pets in the past 5 years?
If it has been longer than 5 years since you have owned a dog, please provide detail of your previous dog-owning experience.*
Please give us information on each animal separately. Please choose the type of your first animal.
Please tell us about your 1st pet's NAME, BREED, AGE, and GENDER:
Is this pet spayed / neutered?
If not spayed/neutered, please provide explanation.
Where did you get this pet?
Do you still have this pet? If not, what happened to it?
Please choose the type of your second animal:
Please enter your second pet's NAME, BREED, AGE and GENDER:
Is this pet spayed or neutered?
Please choose the type of your third animal:
Please enter your third pet's NAME, BREED, AGE and GENDER:
If you have other additional pets, please list them here - and include their names, breeds, ages and genders:
Do you have regular animal visitors with whom your dog must get along? Please describe the breed, gender, age, and personality.*
Describe your past experience with large breed dogs.*
Have you ever given up or re-homed a pet? If yes, please explain*
Please describe your socialization strategy to integrate a puppy or rescued adult into your family (How to train and expose your dog to various situations, people, and animals):*
Describe your past experience in training for desirable behaviors and managing unwanted behaviors?*
Have you attended obedience class or worked with a dog trainer before?
Have you crate-trained your dogs before? Was it successful?*
Are you aware that Pyrenees have a tendency to bark and roam if not securely fenced?
Describe your exercise plan for the dog.*
Please list any expectations you may have for the dog (ie: service dog? livestock guardian dog? family pet? combination of any of those?)*
What other particular activities do you plan to experience with the adopted dog?*
Are you willing to housebreak a dog?
Will the 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?*
Where will the dog be kept when you are not home*
How much time will the dog spend alone during the day*
How much time will the dog spend WITHOUT human interaction during the day?*
What level of activity for the dog would best suit your family?(Low: a slow stroll through neighborhood; Medium: a few hours of playing, physical activities; High: Always ready for physical activities)
Would you consider a dog with special needs such as blindness, deafness, physical limitations, etc.?
Do you have a Gender and/or age preference? If so, what is your preference?*
Have you SUCCESSFULLY MANAGED the following behaviors: (Yes/No/Does not apply): Counter Surfing
Successfully managed a dog with housetraining accidents?
Successfully managed a dog with leash reactivity?
Successfully managed a dog with inappropriate chewing?
Successfully managed a dog with excessive barking?
Successfully managed a dog with fence jumping or barrier reactivity?
Successfully managed a dog that engaged in chasing cats or other smaller pets?
Successfully managed a dog with separation anxiety (whining, destructiveness or acting out when left alone)
Successfully managed a dog with shyness or aggression toward strangers?
Successfully managed a dog with aggression toward other dogs?
Successfully managed a dog with resource guarding
Successfully managed a dog that enjoyed digging in the yard or flower beds?
What three qualities are most important for you to have in your new dog?*
Describe dog behaviors or characteristics that you find challenging. *
Describe the most challenging behaviors you experienced with your dogs and how you managed them.*
Describe the most likely scenario that would cause you to return the adopted dog.*
Have you applied with any other rescue* Choose one: Yes No
Why are you interested in adopting a pet at this time*
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 Advocates of Texas Rescue (GPAT). I hereby permit representatives from Great Pyrenees Advocates of Texas Rescue (GPAT) 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:*
