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Adoption Application

Please Read Adoption Guidelines before filling out the application.

Fill out the form below to submit your request online, or click here to download a PDF copy of the form to mail to us.

Fields marked with an asterisk (*) are required. For any required field that is not applicable, please enter "N/A."

Personal Information

* First Name:

* Last Name:

* Address:

* City:

* State:

* Zip:

* Phone Number:

Alt. Phone Number:

Best Time to Call:

* Email Address:

Alt. Email Address:

* How did you hear about us?

Adoption Information

* I would like to adopt:

Yes No

* I would like help with:

Make a Donation

* Adoption/Fostering Preferences:

Male Female No Preference

* Age Preferences:

Less than 2 Years 2-5 Years 6+ Years No Preference

* Why do you want a Great Pyrenees?

Household Information

* Where do you live?

House
Condo
Apartment

Other

* Are you aware that Pyrs have a tendency to bark and will roam if they are not securely enclosed?

* Please indicate if you own the following equipment:

Other Equipment

* Please tell us how your yard is secure:

* Where will the dog spend the day?

* Where will the dog sleep?

* Please list the people in your household and their age:

* Are the members of your household aware that you plan to adopt/foster a dog?

Yes No

* Do the members of your household support your decision to adopt/foster a dog?

Yes No

Dog/Pet Experience Information

* Do you own other dogs?

Yes No

If yes, please list ages, sex, and spay/neuter information:

* Do you plan to use heartworm preventative?

Yes No

* Date of last dosage for current dogs:

* Do you own other pets?

Yes No

If yes, please list ages, sex for each pet:

* Have you ever owned a Pyr?

Yes No

If yes, what happened to it?

* Have you ever owned other dogs?

Yes No

If yes, what happened to them?

* Are you willing to travel to acquire a rescue dog?

Yes No

* Are you willing to housebreak a dog?

Yes No

* Have you applied to any other rescue organizations?

Yes No

If yes, please indicate their name and contact information?

* Veterinarian's Name:

* Veterinarian's Phone:

Please contact your vet and authorize them to release information to Northeast Pyr Rescue

* Other comments:

* Verification:

Adopt & Surrender

Adoption Application

Please Read Adoption Guidelines before filling out the application.

Personal Information

Adoption Information

Household Information

Dog/Pet Experience Information