First Name:
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Last Name:
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Address:
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City:
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State:
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Zip:
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Phone (Day):
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Phone (Evening):
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Best Time to Call:
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E-mail Address:
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How Did You Hear About Us?
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How Familiar Are You with the Breed?
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Very Familiar Somewhat Familiar
Would Like to Know More
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Please tell us about Pyrs you have owned or known:
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I Would Like To:
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| Transport: NGPR avoids transporting dogs long distances when possible, and usually only requires trips within a 75-mile radius of your home. |
Transport a Pyr (2-3 hours' round trip)
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| Make Home Visits: NGPR has a number of volunteers spread throughout our region and tries to find, whenever possible, the closest volunteer within an hour's traveling time. |
Make a Home Visit (within an hour's drive)
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| Evaluate: Similar to home visits, NGPR tries to find the closest volunteers within an hour's traveling time to visit and evaluate dogs who need rescue. It is also possible to request that that dog be brought to you, or to meet somewhere in between. |
Evaluate a Pyr (within an hour's drive)
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| Donate a Service: Do you have a special skill? We would like to hear about it. Services could include bookkeeping, legal, financial, technical, artistic or other assistance. |
| Donate a Service |
Please Specify:
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| Donate a Product: Do you manufacture or make something that NGPR could use or auction? You may be entitled to a tax deduction for your donation. (Please e-mail NGPR director Barbara Mattson to see if your product is eligible.) |
| Donate a Product |
Please Specify:
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| Provide a Foster Home: Foster stays can be as short as a few days, or they can last for a week or longer. Please indicate whether you can provide short- or longer-term foster care. |
Short-term foster (1-3 days)
Longer-term foster (a week or longer)
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Potential Fosters, Please Tell Us About Yourself and Your Pets
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Preferences for Adoption/Fostering
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Sex:
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Male Female Either
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Age:
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Under Two Two to Five Any Age
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Where Do You Live?
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House Condo/Apt. Other
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If "Other", please explain:
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Do You Have:
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Fully Fenced Yard Chain-link Kennel
Trolley, other tying device Large Crate
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Please tell us how your yard is secure:
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Where Will the Dog Spend the Day?
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Where Will the Dog Sleep?
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Number of People in Household:
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Ages of Children:
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Own Other Dogs Now? (List Age, Sex, Whether Spayed/Neutered)
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What Brand of Heartworm Preventative Do You Use?
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Own Other Pets Now? (List Type, Age, Sex, Whether Spayed/Neutered)
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Are You Willing to Housebreak a Dog?
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Yes No
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Your Veterinarian's Name:
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Your Veterinarian's Phone Number:
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Any Other Comments?
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