SFCF Rescue Application

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Rescue

SAMOYED FANCIERS OF CENTRAL FLORIDA, Inc.
RESCUE APPLICATION FORM

The most successful adoptions are created by matching the right dog with its best possible household. Please answer the following questions so we can find the dog most suited to you. (We reserve the right to refuse an applicant)

Thank you.

First Name(s): (If married please list both.)
Last Name:
Address:
City, State, Zip:

Home Phone	Work Phone	E-mail Address:

Occupation - Position(s):
How long employed:

Do you have a gender preference?	Reason for this preference?

Expected life of a Samoyed is 10-14 years. Many older dogs make wonderful companions and have great manners. Please consider an older Samoyed as younger dogs do require a lot more work.

Do you have a preferred age?
Do you accept that the dog will be spayed/neutered?

What is your current housing status?
If renting, is the landlord agreeable to dog ownership?
May we contact the landlord to verify the renter's policy on pet ownership?
Is your yard fenced?
If yes, what type of fencing:
Do you padlock your gates (if applicable)?

How many adults are in the household?
How many children in the household?
What are their ages? (If applicable)
If there are no children in the house, do you have children who visit your home on a regular basis?
Does the entire family want this dog?
Who will be primarily responsible for taking care of the dog? (Feeding, walking, grooming, etc.)
Are you aware that Samoyeds can be runners, barkers, diggers, chewers and require a lot of grooming time?

Florida is the heartworm capital of the world. Heartworms come from mosquitoes biting the dog.
Was (were) your last dog(s) on heartworm preventative?
Will the cost of caring for this dog fit comfortably into your budget? (Food, monthly heartworm; flea preventative, annual vaccines, crate, bedding, toys, grooming supplies, and emergency situations?
How many hours a day would the dog be left alone?
Where will the dog be primarily kept?
What pets are currently living in your household right now?

Do you own or have you ever owned a dog before?
If yes, please answer the following about current and previous dogs.

	Pet 1	Pet 2	Pet 3	Pet 4
Pet's name
Breed or type
How long have (did) you own them?
What happened to them?

What activities did you do with it (them) (obedience classes, taking for walks, etc.)?
How did you correct or train this (these) dogs?
Would you be willing to supply a copy of veterinary records on this (these) dog(s) and name , address and phone number of your veterinarian?
If yes please provide the following for your current or most recent veterinarian.
Veterinarians Name
Veterinarians Address
Veterinarians Phone Number

How did you hear about the Samoyed breed?
If something happened to you, who would care for this dog?
How did you learn about Samoyed rescue?
What are your plans for this dog?
Are there other things you might like to try or learn more about to do with your dog? e.g. Obedience, agility, weight pull/carting, hiking/backpacking, herding, therapy, grooming, assisting with Samoyed rescue, joining national or local Samoyed breed club.

Rescue is supported by individuals and some dogs may have extensive medical condition which must be handled before the dog can be placed. As such, SFCF requests a donation of $150 to help offset these costs.
Are you agreeable to this?

Can you please tell us a little about yourself and your family?
(Your home, job, hobbies, interests):

Do you have any questions or comments?

Date:
Signature

A COPY OF THE OFFICIAL REGISTRATION AND FINANCIAL INFORMATION MAY BE OBTAINED FROM THE DIVISION OF CONSUMER SERVICES BY CALLING TOLL-FREE 1-800-435-7352 WITHIN THE STATE. REGISTRATION DOES NOT IMPLY ENDORSEMENT, APPROVAL, OR RECOMMENDATION BY THE STATE.

100% OF THE CONTRIBUTION OR PROCEEDS WILL GO TO SFCF, INC. FOR THE BENEFIT OF ITS SAMOYED RESCUE PROGRAM. REGISTRATION NUMBER CH-12613

Pat Turba - 13535 Bristlecone Circle Orlando, FL 32828

Phone (407) 281-6774 E-mail – rescue@floridasamoyeds.org