Release Dog Interest Form

Are you involved with Canine Companions?

YesNo

In what capacity?

Do you have a staff contact that you work with? If so who?

Would you like to get more involved?

YesNo

How did you hear about Canine Companions?

If you were referred by a friend, please let us know who

How many dogs are currently in your household?

How many pets in your household, besides dogs?

Please specify types of other pets

I am willing to provide information requested by Canine Companions if a dog is placed with me.

(Medical, behavioral, surveys, etc.)

*

I am willing to pay the adoption fee.

(The fee to adopt a released dog is $1,000. Do you agree to pay for that dog if you are placed with a released dog from Canine Companions)

*

I am willing to abide by the fence policy.

(Canine Companions does not provide specific off leash training. Therefore, we ask that all released dog adopters keep the dog on leash anytime they are not in an enclosed area)

*