Owning a dog requires a commitment of both money and time. On average, expenses for a healthy Samoyed run upward of $600 per year. You’ll need to cover food, vaccinations, heartworm preventative, flea treatments, and yearly vet visits. Trips to the groomer can cost $40-60 or more. Training classes, a pet sitter or kennel while you’re on vacation, a medical issue, even if it’s minor, can drive your costs up even more. You must also consider the requirements on your time. Dogs need to be exercised and played with, trained, cleaned up after, and fed. A bored or lonely Samoyed will frequently bark, dig or chew. They want to be with you when you’re at home, and travel with you when you’re away. They live 12-14 years on average, and can live to be as old as 18. Make sure you take into account any future plans, such as having children or moving, that could impact your commitment to spend the time and money necessary to give a dog a home for the rest of its life. * = required field
Name: *
Occupation:
Co-Applicant:
Complete Address: *
City: *State: *Zip Code: *
Email Address: *
Home Phone (include area code): *
Cell Phone (include area code):
Work Phone (include area code):
How did you hear about us? If there is a particular dog you would like more information about, which dog(s)? (Dogs are listed on www.sfsr.org.)
A successful adoption depends on matching the right dog with the right home. So that we may assist you with this selection, please answer the following questions as completely and as honestly as possible. Thank you!
Do you: -- Please Choose -- Rent House Own House Rent Apartment Rent Condo/Townhouse Own Condo/Townhouse
If other, what?
If renting, do you have permission from the landlord? -- Please Choose -- NO YES
Landlord's phone (include area code):
How many adults live in your household? Ages?
How many children live in or frequently visit your household? Ages?
Why do you want a dog?
Have you ever owned a dog before? -- Please Choose -- YES NO Breeds
What happened to them?
Ages and breeds of dogs currently in your household?
Does entire family want the dog? -- Please Choose -- YES NO
What other types of animals live in your house?
What do you know about Samoyeds and what about the breed attracts you?
Do you have a sex preference? -- Please Choose -- Male Female Either
Would you consider adopting a Samoyed mix?
Minimum age preference? -- Please Choose -- 0 - 1 Year: Puppy 1-3 Years: Teenager 3-5 Years: Young Adult 5-8 Years: Mature Adult 9+ Years: Silver Sammy No Preference
Maximum age preference? -- Please Choose -- 0 - 1 Year: Puppy 1-3 Years: Teenager 3-5 Years: Young Adult 5-8 Years: Mature Adult 9+ Years: Silver Sammy No Preference
Is your yard fenced? -- Please Choose -- YES NO Fence type and height (Note that fence height should be judged by the lowest section of your fence.)
If you do not have a fence, where and how will dog be exercised and allowed to eliminate?
What member of the family will primarily be taking care of the dog?
Where will the dog primarily be kept when people are at home? --Please Choose -- Loose in House Run Loose Outside Loose in Yard Tied Up Crate in House Kennel Garage Basement Other (Specify below)
If other, where?
Where will the dog primarily be kept when people are not at home? --Please Choose -- Loose in House Run Loose Outside Loose in Yard Tied Up Crate in House Kennel Garage Basement Other (Specify below)
How many hours a day will the dog usually be left alone?
Where will dog sleep at night?
Have you ever taken a dog through obedience? -- Please Choose -- YES NO
When/Where?
Are you willing to take this dog through obedience training, if needed? -- Please Choose -- YES NO
If you move, what will you do with the dog?
What veterinarian do you use or have you used in the past or do you plan to use?
May we contact your veterinarian? -- Please Choose -- YES NO
Veterinarian's city and phone number?
How else have you tried to obtain a Samoyed?
Are you willing to allow an SFSR representative to visit your home? -- Please Choose -- YES NO If no, why?
Questions or Comments?
All of the information I have provided on this application is, to the best of my knowledge, true and complete. I understand that falsifying answers on this application, or at any other time during the adoption process, disqualifies me from the adopting of a Samoyed from SFSR. By submitting this SFSR Screening Form, I attest to the accuracy of the information I have provided.
We reserve the right to refuse any applicant.
Because of the expenses incurred from spaying/neutering, vaccinations, and other veterinarian care, San Francisco Samoyed Rescue asks a donation of between $150.00 and $400.00 to help offset our operating costs. We are a 501(c)(3) all-volunteer, non-profit corporation.