Surrender

Please fill out this application if you would like to surrender your Cane Corso (must be spayed/neutered and up-to-date on all vaccinations). Upon receipt of a photo, certificate of sterilization and vaccination records, we will gladly post your dog on our website. It is in everyone's best interest to be completely honest when filling out this form, as we use the information you provide to best match the Cane Corso rescue to their new forever home.

Name:
E-mail:
Street Address:
City:
State:
Zip:
Phone 1:
Phone 2:
Dog's Name:
Date of Birth or Age of Dog:
Sex:	Male Female
Owned since:
Color:	Black Brindle Fawn Formentino Other
Height:
Weight:
Has the dog ever bit anyone?	Yes No
Has the dog ever TRIED to bite anyone?	Yes No
Has the dog ever demonstrated aggressive, violent or inappropriate behavior?	Yes No
If you answered "Yes" to any of the above 3 questions, please explain in detail:
Is the dog spayed or neutered?	Yes No
Is the dog in good health with up-to-date vaccinations AND heartworm preventative?	Yes No
If you answered "No" to the previous question, please explain in detail:
Please describe any medical condition(s) the dog has been diagnosed with (e.g. dysplasia, mange, cherry eye, epilepsy, etc.):
Vet's name, address and phone number:
Please describe in detail WHY you want to surrender your dog:
How did you get your dog?	Breeder Pet Store Rescue/Shelter Other
Name, address and phone number of the breeder, pet store or rescue/shelter:
Have you notified them that you now want to surrender the dog?	Yes No
Type of registration papers the dog has:	AKC ENCI FCPR ICCF No papers
Type of certifications the dog has:	CGC TDI ATTS-TT None
Where does the dog primarily live?	Inside Outside
When the dog is outside, please describe the shelter it has:
Is anyone home regularly during the day?	Yes No
Do you own any other pet?	Yes No
If "Yes", please describe the type of pet(s) AND if you intend on surrendering them as well:
Which type(s) of homes would you recommend the dog to be placed in:	Single female Single male Adult couple (no children) Family (childen ages 0-5) Family (children ages 6-12) Family (children ages 13-17) Household with cats Household with female dog Household with male dog
Any other info that would help us determine the best home for your dog:
I understand that I MUST e-mail photos of my dog to: mail@canecorsorescue.org (with the dog's name in the subject line).	I agree I disagree
I certify that all information I provided in this surrender application is true and complete.	I agree I disagree

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