ECGRR – Application For Adoption – page 2 of 4

IMPORTANT: ALL FOUR (4) PAGES MUST BE COMPLETED FOR YOUR APPLICATION TO BE CONSIDERED
Incomplete/partially completed applications are purged from our system after 24 hours.

This page is to gather some basic information to help match you with available ECGRR dogs.

Please note: * indicates a required entry

Referred to ECGRR by	Referred to ECGRR by Internet Friend Family Co-worker Previous Adopter News Media other:
Residence status	Residence status Own Rent other: Do you own or rent your home?
Time at Residence	How long have you lived at this address?
Property Description	Briefly describe your property. Example: fenced back yard, lot size, stairs, etc.
Prior Pets	Briefly (in 20 words or less) list all prior pets you have had.
Current pets	Current pets NONE Female dog(s) Male Dog(s) Small dog(s) Cat(s) Bird(s) other: Please indicate current pets in your household.
Ages of household members	Separate with a comma (i.e. 40,39,10)
Household activity level	Household activity level Very Active Active Moderately Active Calm other:
Family Allergies or Medical	Family Allergies or Medical Yes No Is there anyone in the home that has allergies or other medical conditions that need to be taken into consideration before adopting a dog?
Familiar dog breeds	Briefly describe the breeds you are most familiar with. Example: labs, poodles, goldens, shepherds, ...
Prior Likes	Briefly explain what you like most about dog ownership?
Prior Dislikes	Briefly explain what you like the least about dog ownership?