| E-mail Address: * | |
| First Name: * | |
| Last Name: * | |
| Address1: * | |
| Address2: | |
| City: * | |
| State: * | |
| Zip Code: | |
| Phone Number (cell): | |
| Phone Number (home): * | |
| Phone Number (work): | |
| Would you like to receive our newsletter? * | yes
no |
| Would you like to be included on our general mailing list? * | yes
no |
Your donation will allow us to continue to help Schnauzers in need. Donations may be made on our website through PayPal, or if you prefer to write a check, please make it payable to NJSRN and mail it to PO Box 36, Fanwood NJ 07023.
DONATION, if any (not required, but very much appreciated): * | |
| Name of Dog: * | |
| AKC Registered Name and Number (if known): | |
| Gender: * | female
male |
| Spay/Neuter Status: * | dog has been spayed or neutered
dog is intact |
| Date of Birth (if known): |  |
| Approximate Age: | |
| Description: * | |
| Size: * | |
| Weight: * | |
| Color: * | salt & pepper
black
black & silver
other |
| Other Color: | |
| Ears: * | cropped
natural |
| Tail: * | docked
natural |
| Breed: * | purebred Miniature Schnauzer
Schnauzer mix (non-shedding)
Schnauzer mix (shedding) |
| Mixed with (if known)? | |
| Ever been bred (if known)? * | yes
no
unknown |
| If yes, when? | |
| Most recent vaccinations (date and type): * | |
| Where did you get this dog? * | casual breeder or show breeder
pet shop
shelter
rescue group
friend or relative
gift
stray
other |
| Explain (include name of breeder, shelter, rescue group, or other, if known): | |
| on (approximate date): * | |
| at (approximate age): * | |
| If this dog was FOUND, please give location and date: | |
| Reason for rehoming your Schnauzer: * | |
| Do you have a timeframe in mind for surrendering your Schnauzer? * | yes
no |
| Please explain when you would like to surrender your Schnauzer: | |
| Veterinarian: | |
| Clinic: | |
| Address1: | |
| Address2: | |
| City: | |
| State: | |
| Zip Code: | |
| Phone Number: | |
| Is this dog housetrained? * | yes
no
unknown |
| Is this dog crate trained? * | yes
no
unknown |
| Is this dog leash trained? * | yes
no
unknown |
| Does this dog get along with other dogs? * | yes
no
unknown |
| Does this dog get along with cats? * | yes
no
unknown |
| Does this dog get along with children? * | yes
no
unknown |
| Does this dog ride well in a car? * | yes
no
unknown |
| Has this dog lived with children? * | yes
no
unknown |
| If yes, what age(s)? | |
| Does your Schnauzer have any known medical or behavioral problems? * | yes
no
unknown |
| If yes, please specify: | |
| Has this dog ever bitten or shown any aggressive tendencies? * | yes
no
unknown |
| If yes, to whom and under what circumstances: | |
| Is this dog possessive of toys, food, or his people? * | yes
no
unknown |
| If yes, please explain: | |
| Has this dog lived with other animals? * | yes
no
unknown |
| If yes, what type(s)? | |
| Approximately how many hours a day is your Schnauzer alone? * | |
| Is this dog a house pet or an outside dog? * | house pet
outside dog |
| How frequently must he go outside? * | |
| How does he tell you he needs to go outside? * | |
| How do you exercise your Schnauzer? * | walks
kennel run
fenced yard
allow him to run loose |
| Does this dog walk on a leash without pulling? * | yes
no
somewhat |
| Walks best on? * | harness
collar |
| During the day, is this dog happiest in: * | house
crate
outside |
| At night, is this dog happiest in: * | your bed
his or her own bed
house
crate
outside |
| Does this dog know how to go up and down stairs? * | yes
no
unknown |
| Has this dog been obedience trained? * | yes
no
unknown |
| Who had the major responsibility for training this dog? | |
| How does this dog respond to commands? * | excellent
good
fair
poor
when he wants to |
| Please describe the personality and temperament of your Schnauzer: * | |
| What food do you feed your Schnauzer? * | |
| Quantity and frequency: * | |
| Does this dog need a dental cleaning? * | yes
no
unknown |
| Is your Schnauzer on heartworm preventative? * | yes
no
unknown |
| If yes, what type? | daily
monthly |
| Date last given? | |
| How long since his last grooming? * | |
| Please describe, in your opinion, the best type of home or home environment for this dog: * | |
Please obtain a copy of your Schnauzers medical records, including spay/neuter certificate, Rabies certificate, and last DA2HPPv shot. A photo would also very much help us in placement.
Verification (read the statement above and type your name here): * | |
|
| Verification Code: |  |
| Enter Verification Code: * | |
|
| |
| * Required | |
