GEPDA USA ADOPTION CONTRACT
Group Education to Protect and Defend Animals
õõõõ Adoption Application õõõõ
DATE:
NAME:
ADDRESS:
CITY:
STATE:
ZIP:
EMAIL:
HOME PHONE:
WORK PHONE:
CELL PHONE:
Will any of these numbers allow us to call you without asking us for an access code/caller ID?
Your birth date:
What is your occupation/position?
Do you own or rent?
If you rent, Name and Telephone Number of your Landlord:
Name and Birthday of your Spouse or Domestic Partner:
What is your Spouse or Domestic Partner's occupation/position?
List all others in the home who may have contact with the dog, and their relationship to you: (see below)
Name Age Relationship to Applicant
______
You are interested in Dog’s Name (s) ______(or describe dog you would like)
If the pet you have selected is not available, please let us know if you would take an alternate pet like the one you like (as we do keep looking for you if many applications are submitted, and all are good for that one dog) or what exactly you are looking for.
Why are you interested in this particular dog?
You would like a dog that is male or female or EITHER (please underline)?
Preferred age range: Youngest: open? Oldest:
Please underline: Would you like a dog Spayed or Neutered or NOT Spayed/Neutered?
What qualities would you like in a dog?
What do you NOT want in the dog that you get?
What do you think the hardest part of having a dog will be?
How will you exercise your dog and if so, how often?
Please describe where and how you will keep this dog socialized?
Have you had experience with this breed of dog?
What methods will you use to correct your dog for behaviors you find inappropriate?
Please list your current dogs, cats or other pets and their breed/age/gender/if they are spayed or neutered or not spayed or neutered:
Please list your previous dogs, cats or other pets and their breed/age/gender/if they were spayed or neutered or not spayed or neutered/and cause of death:
*Many of our rescues have had severe abuse, neglect, abandonment backgrounds in their struggle to survive, As a result, being in shelters for long lengths of time, their behavior could result in temporary issues which may not allow their true personalities to shine in the first two weeks in your home environment. This could include potty training, marking territory inside/outside of home, nipping/jumping, chewing, dominance, unnecessary barking, anxiety separation, car sickness, etc. This is why GEPDA provides you with a prof. trainer.*
URGENT: Please read carefully. Are you willing to provide a two-week trial period for the dog to settle into his/her new home/routine/lifestyle, as long as everyone and pet is safe and CALL THE GEPDA TRAINER, Donna Johns at 408-225-6042, if there is an issue before giving up on your new doggy? Response_____ all parties involved, please initial:
URGENT: Please read carefully. Are ALL parties committed and willing to make this work and to train and or continue training your new adopted pet for potty training, chewing, barking, separation anxiety, marking, mouthing, as in nipping or any issue with help from our trainer or one of your own trainers, before giving up on the pet in the 2 week trial period as long as everyone, including the pet is safe? Response______Please initial:
Can you commit to caring for a pet for its lifetime which could be up to 15 or more years?
It Is imperative that the dog must have flea protection once a month as in Advantage, Front Guard, something from your vet as in Revolution, etc. Would you be willing to give your pet this on the scruff of their neck to prevent fleas once a month?
If not, please let us know why and if yes, what would you most likely use?
If your dog requires grooming as in Poodles, Bischon’s, Yorkies’, etc., are you willing to have this done and can afford this, several times a year to prevent matting and help with sanitary issues? _____Would you bathe your pet to keep clean during its lifetime? ___
What will you do with your pet if you have to move several times in its lifetime and expense becomes a factor or you have to move to a place where they do not accept pets or are limited to a certain number of pets?
Have you ever taken or returned a pet to an animal county control shelter or asked to give up your pets from an animal control shelter/officer and if so, why and when did this occur?
What would you do with your pet if you or someone in your family develops
Allergies?
Would this be a possible reason to return the dog?
Due to our economy, what would you do with your pet if your family has children, pregnancies occur, divorce, loss of job(s) home(s), and expense becomes a factor? Would this be a reason to give up your pet?
For what reason(s), would you seriously return a dog and why you would not have a trainer/behaviorist help you with this situation?
URGENT: If you have children in your family now, or many children visiting, have they been taught how to treat a dog with respect AND how would they treat the dog? ______
URGENT: Will you prevent children from placing their faces/heads close up to the dog’s eye level, which is considered confrontation mode when they are awake AND sleeping and never to startle them? _____Will they be taught not to do this with any dog they are around, as well as visitors be taught this that enter your home, as in children and adults? ______
URGENT:If you do not have children, but anticipate in the future, or guests/relatives with children that could be around your dog (s), would you be willing to teach children this and to respect the dog? ______
Where will your dog stay during the day? Inside/outside or both? ______
If outside during the day for how many hrs? ______Do you have shelter or a garage if it rains or a doggie door where it can go inside or outside? Please explain what you have for them: ______
______
*GEPDA does not adopt to individuals/families that intend to keep their dogs for outside living only or for use as guard dogs. When people are inside the house, the dog should be inside the house as a member of the family or given a choice with a doggy door.* Do you feel comfortable about this? ______
Please describe the area where the dog will stay during the day and area where they will stay at night:
How will they sleep at night - your bed, their bed, floor, couch, garage, kitchen, crated?
Please describe your fence in the backyard: (including Type and Height of Fence):
If you have no fence completely enclosed around your property in the backyard, please describe the area and if you will be able to walk the dog on a leash for potty/exercise:
How many minutes/hours will you spend with your dog on a typical weekday/ weekend?
What is a normal day for you on weekdays and the weekends?
Would you allow your dog on any type of human furniture as in bed, sofa, or chair?
Why or why not?
What will you do with the dog when you go on vacation?
Have you ever taken a puppy/dog through puppy class or an adult dog through obedience class?
If yes, please provide name of training class and when this occurred aprox.?
Which trainer/school would you take your adopted dog to or would you prefer not to and why?
Please list the name/city or phone number of your current Veterinarian or one you feel you will be using for your new dog:
Please supply the names and phone numbers of 2 references not in the family:
Please make sure all parties (adults over 18), initial in each part of contract as in agreement to adopting a pet from GEPDA in the GREEN FORMAT CONTRACT BELOW IF YOU AGREE: Thank you.
I agree and understand that this animal is being offered for adoption by the pets current guardian as part of GEPDA’S Adoption Program. GEPDA will take back all pets that were adopted from a GEPDA Representative AT ANY TIME of its lifetime, if animals do not work out after the 2 week trial period. All fees are non-refundable and are used for donations to GEPDA, after a 2 week trial period. GEPDA cannot be responsible for property damage, injury or illnesses caused by interaction to your pets/family or previous health problems that were unknown at the time of adoption to GEPDA and the owners will be responsible for all vet bills.(INITIAL)
I agree and understand that GEPDA makes no representations regarding the truth and accuracy of any statements contained in this pet’s biography. The pets’ current guardian provides all representations contained therein and will provide a healthy pet at the time of the adoption unless otherwise stated, as in the best health as they know it. We don'tplace an animal knowing that it will harm someone,unless provoked intentially or unintentially, or is not beginning to socialize at the time of the adoption. (Initial)
Remember these pets come from RESCUE and we cannot always guarantee a pet having perfect health, but we do the best to our ability and are responsible for providing all initial shots, alteration, micro chip and a general health check, but we cannot take upon additional vet. expense before/after adoption – as in during/after the 2 week trial period. We DO always take back the pet though, for any reason and at any time. (INITIAL)
I agree and understand that I am completely responsible for the care and treatment of this animal once I adopt this animal from its guardian/GEPDA BEORE AND AFTER 2 WEEK TRIAL; (initial)
I agree and understand that GEPDA is not responsible for the care or treatment of this animal, nor any veterinarian bills incurred BEFORE/AFTER adoption is final; before/after the 2 week trial period;
(initial)
IF GEPDA PET IS SICK OR NOT DOING WELL AFTER YOU RECEIVE THE PET AS IN WITHIN YOUR 2 WEEK TRIAL PERIOD, PLEASE CALL US ASAP, SO WE CAN ASSESS THE SITUATION AND PLEASE TAKE TO YOUR VET. (initial)
I will return my pet to GEPDA if I am unable to care for it in the future. (Animals are not to be surrendered to an animal shelter or to any private parties.) (initial)
We ______(state full name of at least 2 significant parties in family)
will care for, protect and provide for this animal (s) in an appropriate and loving manner to the very best of my/our abilities. I will provide vet care for all illnesses and “shots” upkeep and keep ID tags on this pet at all times with current information, and micro-chip. We promise to have 1 routine vet check before/after 2 weeks arrival for pet’s general health and flea protection with heartworm, fecal sample, parasite check. GEPDA cannot be held responsible for any vet bills incurred at this check up. GEPDA pets will not be placed unless altered, shots and micro chipped and with a general health check from a vet. Thank you for wanting to save a life!
.
Adoption/Donation in a cheque/cash only, is due at time of approving your pet for adoption. Remember you are saving a life and giving it a warm and loving home, where it has seen the worst and deserves the best and has been given the basics to start out with a healthy life! It is up to the adopters to continue where we left off to provide care, love and to shelter/protect it from harm’s way, being its Pack Leader. (initial)
“Group Education to Protect and Defend Animals. (501c3) www.gepdaus.org
MaryAnn Lima
GEPDA Director
408-309-2667 (cell)
Nita Anderson
GEPDA Director
.
408-265-8424 after 11:00am (hm)
Donna Johns
DJ’S Clever K-9s
25 Yrs. Professional Trainer/Behaviorist Home Sessions & Classes San Jose Area
408-225-6042. (hm)