Surrender Form – French Bulldog Fanciers of Canada

surrender application

We 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.

Date *
Name Full Name *
Valid Email Address *
Your Phone Number *
Address *
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Dog's Name *
Date of Birth *
Description of Animal *
Sex of Dog *
Male IntactMale NeuteredFemale IntactFemale Spayed
Tattoo 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? *
yesno
Did you notify the breeder?
yesno
If this dog is not purebred, what is its mix?
Colour & Markings of Dog *
Weight of Dog?
Do you have registration papers for this dog? *
YesNo
Is this dog a:
House PetYard/Kennel DogShow DogBreeding DogOther
Where 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? *

Is this dog housebroken?
YesNo
If 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 issues
Details of behavioural issues checked above:
Is this dog good with: *
catsother dogs - same sexother dogs - opposite sexchildren - all ageschildren - older only
Has this dog lived with children?
YesNo
If so, please detail ages of children dog has lived with:
Is this dog crate trained?
YesNo
Has this dog ever shown aggression to anyone or anything (cats, dogs, children, etc) - include details: *
Has this dog ever bitten anyone?
YesNo
If you answered Yes please elaborate:
Has this dog been exposed to or lived with livestock or horses? *
YesNo
What 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?
YesNo
If this dog has had obedience training, please elaborate:

I certify that I: *
do own the dog I have described abovedo NOT own the dog I have described above
If 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 history
I 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 *