APPLICATION Adoption/Foster Form Phone Adopt or Foster? Adopt Foster Prior Samoyed YesNo Previously Adopted from SRSC? YesNo Ever had a dog? YesNo Do you currently have other pets? YesNo If you have other pets, please specify what kind, how many, breed, if altered, and ages. First Name * Email Address * Last Name * Phone Number * Co-Applicant First Name Co-Applicant Last Name Co-Applicant Phone Number Street Address * City (SRSC only serves So CA cities) * Check samoyedrescue.org for rescues in other areas County * LA Orange Riverside San Bernardino San Diego Ventura State * CA CA Only Zip Code * Housing Type Single Family Residence Townhome Condo Apartment Other Rent or Own? RentOwn Yard? YesNo Fenced Yard? YesNo Yard Size Less than 300 ft 300-600 feet more than 600 ft Number of adults in home Children in home YesNo Number of children Ages of adults Ages of children Dog Care - hours alone per day less than 2 2 to 5 hours 5 to 8 hours more than 8 When you're at home, dog will be Inside Outside Inside & Outside When you're at away, dog will be Inside Outside Inside & Outside Dog Preference - Name Dog Preference - Gender Male Female Either Dog Preference - Age <1 1-3 3-5 >5 No preference Dog Preference - Size Small Medium Large No Preference Breed Preference Purebred only Mix will be considered No preference Anything else you'd like us to know?