Great Pyrenees Rescue and Sanctuary

First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

Email*

Cell Phone*

Dog's Name:*

Breed of dog*

Date of birth*

Rabies# Microchip# License#*

Where did you get the dog from, please list name, number and address. *

Please explain why you are releasing this dog. *

Veterinary Info*

Spayed/Neutered:

If your Dog is on any Medications please list the names here.

Health Records Available:

Shots Current:

Obedience Trained:

Dogs Temperament:*

Tell us your dogs Living Environment:*

Has this Pyr ever bitten/attacked any person for any reason?

Is the Pyr housebroken?

Please Describe your dogs Habits and Favorite Things:*

Do you fully release your dog to Pyrescue and understand that you are giving up your rights to this dog. Great Pyrenees Rescue reserves the right to refuse or deny any application. “Application will not be considered if all fields are not filled out appropriately"