SCLRR: Dog Listing Agreement

Fill out once per dog

PLEASE FILL OUT THIS FORM BELOW, CLICK ONCE ON "SUBMIT LISTING" AT THE END, AND THEN PRINT THE RESULTING PAGE OUT! Thank you!

If you have multiple dogs you wish to list, please fill out this form ONCE SEPARATELY FOR EACH DOG. Thank you. (Multiple dogs are $25 each.)

An asterisk indicates required information.

We regret that we cannot accept any dogs that are aggressive or have bitten someone.

Please fill out this form completely and return with a $25 non-refundable donation made payable to SCLRR and mail to address below. Be sure to include a copy of your dog's spay/neuter certificate, current (within the last year) vaccinations (rabies and DHLPP), and a current picture of your dog. Failure to include any of these items will delay the processing of your listing application.

SCLRR is a non-profit tax-exempt rescue organization. The donation goes to cover our operating costs including postage, telephone fees, website space, time and efforts in matching and interviewing families and dogs. We suggest you make your own copy of this document before mailing it to us. If we are successful in helping to place your dog, we would appreciate an additional donation.

Owner Info
*Owner's first name:		*Owner's last name:
All phones format xxx-xxx-xxxx. Be sure to include area codes!
*Home phone:		Best time to call:
Work phone:		Best time to call:
Other phone:		Best time to call:
Fax phone:		Best time to call:
*Address:		*City:
*Zip:		*Email address:

General Info on Dog
*Name of dog:	Is dog co-owned?
How long have you owned this dog?	*Age (or estimate):
*Is the dog a mix?	*Sex:
Weight: lbs.	*Color:
Any markings?	Dog's address (if at a different location from owner's above):
Breeder's name & address (if known):	Have you notified breeder about need for new home?
What was breeder's response?	Are AKC papers available?
Will you provide to new owner?	If not from a breeder, list source & location:
*If dog from shelter, did shelter request dog be returned to them?	What brand food does dog eat?
How much does dog eat daily?	How many feedings/day?

Health Info on Dog
List veterinarian (name, phone):	*Are shots up to date?
*Will you provide copy of health records to new owner?	*Is dog spayed/neutered?
Does dog have any physical problems?	If yes, describe briefly:
*Allergies?	*On medication? If yes, describe:
If unspayed female, when was her last heat cycle?	Pregnant now?
Has had puppies before?	If intact male, has he been bred before?
*Is dog aggressive to other dogs?	Does dog roam?

Training Info on Dog

Has dog had obedience classes?
If yes, what school/trainer?

Any other training?

Guard Obedience Agility

Tracking Hunting Other
If Other, describe:

*Housetrained?

*Crate trained?

*Paper trained?

List commands, tricks, skills:

Who in family does dog obey?

Behavior Info on Dog

Dog typically spends days (choose one)

How does dog react to:

Other dogs?		Cats?
Strangers?		Children?
Walking on leash?		Being alone in yard?
Being alone in house?		Being alone in car?
Surprises?		Loud noises?

Does dog:

*Bark excessively?		*Dig?
*Jump fences?		*Chew?
*Show shyness?		*Fight with other dogs?
*Snap or nip at people?		*Growl when you take away food/toys?
*Show fear of children?		*Show fear of men?
*Show fear of women?		*Show fear of other dogs?
If yes to any of the above, please elaborate as needed below:

*Has dog injured/killed other animals?

If yes, describe

*Has dog ever bitten a person?

If yes, describe

*Did wound require medical attention?

*Was bite reported to animal control?

*Was dog quarantined?

What caused this bite?

Personality of Dog
What does dog like best?	Dislike or fear most?
Why is dog up for adoption?	What is the most appealing thing about this dog?
What is the dog's biggest fault?

Bio for dog
Please fill out a paragraph or two in the box on the right to describe your dog to a potentially interested adoptor. Include things like: Dog's personality, how is he with children/other people/other dogs/other pets such as cats? Does he know any tricks (sit, down, etc)? Is he quiet, active, playful? Housetrained? Does he chew, etc?

*Have you tried placing the dog yourself? (describe)
Do you understand that all dogs placed by SCLRR must be spayed or neutered and up to date on their vaccinations? You will be requested to mail or fax copies furnishing proof of spay/neuter & vaccinations for this dog.*		*Do you understand that we may not be able to place this dog due to its age, health, physical condition, temperament, or lack of training?
How did you hear about SCLRR?		*May we give out your phone number to approved applicants who may be interested in your dog?

*I certify that I am the owner of this dog, free and clear of all other interests.		*I certify that this dog is not possessed of any dangerous or vicious propensities and that I have not willfully concealed information about this dog that might indicate such propensities.
*The information I have provided about this dog is true and complete.		*I hereby forever release, discharge and agree to hold harmless and indemnify Southern California Labrador Retriever Rescue, Inc., its Board of Directors, officers, volunteers and agents from all claims, demands, actions, causes of action, or liability of any kind whatsoever arising as a result of or in connection with the adoption or other disposition of the above named dog.

If you have a good photo of the dog, please include it with the application. Please clearly label the back of the photo with the dog's name.

Do not staple application or photo. Include SASE for return of photo if desired.

You can also email a photograph of your dog to SCLRR to pictures@sclrr.org Make sure it is in JPG or GIF format, ideally a head shot of your dog, vertically oriented. BE SURE TO INCLUDE YOUR NAME AND YOUR DOG'S NAME WITH THE EMAIL SO THAT WE CAN MATCH IT UP TO THE APPLICATION!

Southern California Labrador Retriever Rescue, Inc.
4654 East Ave S #108, Palmdale, CA 93552
http://www.sclrr.org * 888-554-ALAB
sclrr@sclrr.org
05/12/08 at 0:30 (CST)