(for best results print with 10 point type)
DATE:__________ BREED:__________________ DOG'S NAME_____________________ OWNER'S NAME:___________________________________ PHONE:__________________ ADDRESS:__________________________________________________ ZIP___________ BREEDER:______________________ AKC#:____________ SEX:_____ ALTERED_____ HOUSEBROKEN:_____ GOOD WITH CATS_____ GOOD WITH DOGS:_____ BARKER:_____ GOOD WITH CHILDREN: Y/N AGES:_________ DIGS: Y/N DOG AGGRESSIVE:_______ SHOT RECORD:______________________________________________________________ REASON FOR RELEASE:_______________________________________________________ OTHER COMMENTS: __________________________________________________________________________ COSTS: __________________________________________________________________________ DISPOSITION OF DOG:
(for best results print with 10 point type)
DATE:_____________ BREED:________________________________________________ SHELTER NAME:____________________________________ TOWN:__________________ SHELTER CONTACT:_________________________________ PHONE:_________________ STRAY: Y/N OWNER TURN-IN: Y/N AGE:__ SEX:__ ALTERED: Y/N COLOR:______
OWNER TURN IN DATE:________ AKC PAPERS: Y/N AKC#____________ HOUSEBROKEN:Y/N BARKER: Y/N GOOD WITH CHILDREN: Y/N AGES:____________ DOG AGGRESSIVE: Y/N DIGS: Y/N GOOD WITH OTHER ANIMALS:____________________ NAME:_______________________ REASON FOR TURN IN:_______________________________________________________ SHOT RECORD:______________________________________________________________ OTHER COMMENTS.
STRAY LOCATION FOUND:___________________________________ I.D.TAGS:_____________ CONDITION OF DOG:_________________________________________________________ OTHER COMMENTS:___________________________________________________________
COSTS SHELTER RELEASE: SHOTS: SPAY/NEUTER: OTHER MEDICAL: OTHER: TOTAL COST: __________________________________________________________________________ DISPOSITION OF DOG: