surrender application Thank YouWe Know This is a Hard Decision to Make Thank you for making the most reasonable decision to place this dog in another loving home. We understand that this is a difficult decision that you are making, and we will try our best to make this process and transition happen as smoothly as possible. Certainly, this is the most loving and humane act you can do for your dog in the event that you can no longer care for him or her. It shows a high degree of responsibility on your part and you will always be held in high regard. Details on the Dog You Wish to SurrenderDate *Name Full Name *Valid Email Address *Your Phone Number *Address *Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeAfghanistanAlbaniaAlgeriaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCentral African RepublicChadChileChinaColombiaComorosCongo (Brazzaville)CongoCosta RicaCote d\'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast Timor (Timor Timur)EcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambia, TheGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea, NorthKorea, SouthKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPalestinian TerritoryPalauPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint VincentSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of AmericaUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWestern SaharaWestern SamoaYemenZambiaZimbabweCountryDog's Name *Date of Birth *Description of Animal *Sex of Dog *Male IntactMale NeuteredFemale IntactFemale SpayedTattoo and/or Microchip Number CKC/AKC or FCI Registration Number How long have you owned this dog? Where did you aquire this dog? *Are you the original owner of this dog? *Is this dog purebred? *yesnoDid you notify the breeder? yesnoIf this dog is not purebred, what is its mix? Colour & Markings of Dog *Weight of Dog? Do you have registration papers for this dog? *YesNoIs this dog a: House PetYard/Kennel DogShow DogBreeding DogOtherWhere does this dog live during the day? *Where does this dog sleep at night? *How long is this dog generally alone during the day? *Current food being fed, how much & feeding schedule? * Behaviour of DogIs this dog housebroken? YesNoIf no, please elaborate on this dog's housebreaking issues: How do you handle housebreaking issues? Behaviour issues of this dog (check all/any that apply) *chews or scratches household itemsdigs holesgets over/under fencesgets into garbageaggressive with catsaggressive with other dogsaggressive with adultsaggressive with childrenother issuesDetails of behavioural issues checked above: Is this dog good with: *catsother dogs - same sexother dogs - opposite sexchildren - all ageschildren - older onlyHas this dog lived with children? YesNoIf so, please detail ages of children dog has lived with: Is this dog crate trained? YesNoHas this dog ever shown aggression to anyone or anything (cats, dogs, children, etc) - include details: *Has this dog ever bitten anyone? YesNoIf you answered Yes please elaborate: Has this dog been exposed to or lived with livestock or horses? *YesNoWhat is this dog's general temperament? *How does this dog react to strangers? *Does this dog ride well in the car? *Does this dog know any commands and/or games? *Has this dog had any obedience training? YesNoIf this dog has had obedience training, please elaborate: MEDICAL HISTORY OF THIS DOGAre there any medical issues concerning this pet that we should be aware of? Vaccination status: *What is used for flea and/or heartworm prevention? *Details of vet care received (if applicable) DISCLAIMERS AND CERTIFICATIONSI certify that I: *do own the dog I have described abovedo NOT own the dog I have described aboveIf you certified you do not own the dog named above, please explain circumstances of surrender: I certify that, to my knowledge, this dog: *HAS bitten any animal or human being within the past 14 days.has NOT bitten any animal or human being within the past 14 dayshas an unknown bite historyI hearby: surrender all my interest in the French Bulldog identified above, if any herein, to the French Bulldog Fanciers of Canada Rescue Representative and request that this dog be rehomed as seems advisable at their discretion. I understand that I am surrendering the above dog of my own free will and in no way can this surrender be construed as a sale. I further understand that I will receive no money or any other consideration as a result of surrendering this dog.Your Name in Full *Date of Digital Signature Above * VerificationPlease enter any two digits *Example: 12This box is for spam protection - <strong>please leave it blank</strong>: