Relinquishment Application

First and Last Name *

Address, City, State and Zip Code *

Telephone:

Email: *

Dog Name

Age

Gender

Dog Breed

Reason for Relinquishment - please explain fully.

Where and when did you acquire your dog?

Does your dog have any health issues including hip or elbow dysplasia? (Health issues do not automatically disqualify a dog for rescue).

Does your dog enjoy the company of other dogs, both large and small? Describe your dog's behavior around other dogs.

Does your dog like children?

Does your dog like cats?

Does your dog like toys or playing fetch? Describe how your dog plays.

Has your dog ever bitten anyone?

Please describe circumstances of any bite history.

Have you been cited by Animal Control for barking, escaping or other causing a public nuisance?

If so, describe the circumstances.

Does your dog sleep indoors, outdoors, in a dog house or garage?

Does your dog jump fences? Height of current fence.

Is your dog able to go to dog parks and beaches?

Does your dog allow you to take food away?

Does your dog guard food against other dogs?

Does your dog allow you to take toys away?

Are you able to help SCGSR care for your dog by making a financial donation or donations toward its care?

Please submit photos of your dog.

Photo 2

Photo 3

Photo 4

Is there any other information you would like to provide regarding your dog to assist SCGSR in finding it a new home?

Applicant certifies that the information provided above is true and correct to the best of applicant's knowledge.