We are happy that you are interested in adopting one of our wonderful shepherds.
Please take the time to fill this application out completely and honestly about you and your family.
With this form we will strive to find a perfect match.
Feel free to add any additional information not covered.



*Please Answer as much Information as Possible

Personal Info
Name: Email: Date (mm/dd/yyyy):
Spouse or Co-Applicant Name: Address: City/State/Zip:
Telephone # (Home): Cell or Work phone:
Best time to contact: Best Number to contact:
Driver's License #: Driver's License State:
Marital Status:
Number of Children: List children ages:
All other persons living with you
(grandparents-another relative-friend)


Employer info
Company name: Occupation: How Long:
Telephone #:

Spouse Employer: 		How Long:


Veterinary Info
Name: Address: Telephone:


List All Current and Previous Pets

Name:     Breed:     Sex: MF     Age:     Do You Still Have?: YesNo
Name: Breed: Sex: MF Age: Do You Still Have?: YesNo
Name: Breed: Sex: MF Age: Do You Still Have?: YesNo
Name: Breed: Sex: MF Age: Do You Still Have?: YesNo


Dog Preference Information:

Are you interested in any specific dog in our program?
If so, which dog and what interested you about him or her?
If that dog is no longer available, can we interest you in another? YesNo          
Do you have a preference in gender for your german shepherd?
Do you have a preference in color? Coat Consideration
Do you have a preference for age?
Are you currently working with any other rescues? YesNo          
What is it about the German Shepherd Dog that interests you?
Are there qualities or traits you are looking for?
What qualities or medical conditions do you feel you could not handle?
Please pick those characteristics you look for in a shepherd:


Please list two (2) personal reference that we can call

Name: Phone: E-mail: Address: Relationship:
Name: Phone: E-mail: Address: Relationship:


If There is anything else you feel you want to add please do so here:



Again, we are an all volunteer group and have full time jobs and families.

We also work hard to match the right dog with your family life. Please be patient and we will get back to you within 7-10 days. Simply Shepherds Rescue Email address: info@simplyshepherdsrescue.org