Dog Surrender Questionnaire Contact InformationDate*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920First Name*Last Name*Phone Number*Best Time to CallEmail Address*City and State of Residence*About the DogIf your pet is enrolled in our adoption program, the information in this section is often used to help create the online bigraphy for your pet.Dog's Name*Breed*Age*Gender* Male FemaleIs this dog spayed/neutered?* Yes No I don’t knowThis dog is:* My pet A stray Someone else’s dog that you are helpingIf this is your pet, why are you needing to find it a new home?*If this your pet, what effort have you made to find a new home for your pet?If this is a pregant dog, a mama with a litter of puppies or puppies and no mama, please enter as much information here as you can.If this dog is a stray, please explain your efforts to reunite him/her with an ownerIs this dog current on his/her vaccines?* Yes No I don’t knowHas this dog been around other dogs, cats, kids?*Has this dog had any training?* Yes No I don’t knowWhat can you tell us about the dogs temperment?*No dog (or person) is perfect. Please describe any challenging traits of your dog. Please be as clear and honest as possible. Behavior issues do not rule out POPP helping, but may affect which foster home the dog could be placed with.Would you be willing to foster/continue to house the dog until he/she is adopted?* Yes NoThis can take anywhere from a few weeks to a couple of months.If you can't foster him/her, can you hold him/her for a few days while we find a new placement?* Yes NoPlease feel free to tell us anything else you think we should know about this dog and the situation.I Understand that POPP has a surrender fee ($25 for spayed/neutered dogs, $50 for intact pets) and I am preparred to pay that fee.* Yes NoSurrender fees are used to help with the costs of preparing pets for adoption.Please attach a couple photos of the dog*Max. file size: 300 MB.Photos must be clear and in jpg or png format. If your pet is enrolled in our adoption program, we may use these pictures in their Pet Finder listing.Acknowledgement of POPP's Ability to Assist* I understandI understand that POPP does not have a shelter, so all the dogs are housed in foster homes. Foster home space is very limited and POPP cannot help every dog in need of a home. I understand that completing this form DOES NOT guarantee POPP will be able bring this dog into their adoption program. A volunteer will let you know if we are able to help.EmailThis field is for validation purposes and should be left unchanged.