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Owner Information  
Name:
Address:
City, State, Zip:
Email Address:
Home Phone:
Cell Phone:
Work Phone:
   
Dog Information  
Dog's Name:
Dog's Sex:
Is this dog spayed or neutered?
Dog's Age and Date of Birth (if known):
Dog's Weight (if estimating, please be as accurate as possible):
Dog's Color:
   
Temperament Information  
Please be as honest in your answers to the following questions.
Is this dog accustomed to and used to children?
Please explain:
Is this dog accustomed to and used to other animals?
Please explain:
Please describe this dog's overall temperament:
Has this dog ever bitten anyone?
Has this dog ever attempted to bite anyone?
Has this dog ever shown aggressive, violent, or inappropriate behavior?
If you answered "Yes" to any of the above questions, please use this space to describe the circumstances:
   
Veterinary Information  
Vet or Clinic's Name:
Vet's Address:
Vet's City, State, Zip:
Vet's Phone Number:
Is this dog's vaccinations current?
Date of last vaccinations, if known:
Has this dog been on heartworm preventative?
   
About the Surrender  
 
   

Please describe all pertinent details of how the dog came to the attention of the NeoRescue, Inc. (for instance, where the dog was found, why the dog is being surrendered/ how the dog was found, etc.)

Please describe the physical condition of the dog. (For instance, general health, coat condition, general fitness, etc.)

Are there any conditions that may need veterinarian treatment. If so, give description (i.e. cherry eye, mange, etc.)

Is this dog adoptable in your opinion? Explain why.

Is there any other information that you can provide that will help rescue find the right home for this dog?

   

By entering your name below, you apply your signature to this form and affirm that all information above is true and correct to the best of your knowledge:

 

 

Please complete this form in detail and accurately.
All fields are required.  If a question does not apply, enter Not Applicable.

Once submitted, one of our volunteers will contact you to discuss your situation.
STOP!  PLEASE READ THIS BEFORE YOU SUBMIT AN APPLICATION TO SURRENDER A NEAPOLITAN MASTIFF.

If you would like to SURRENDER your Neapolitan Mastiff and are serious about this process, there will be a Twenty-Five Dollar ($25.00) non-refundable application fee, which is tax deductible.  PLEASE NOTE THAT THIS NON-REFUNDABLE APPLICATION FEE DOES NOT GUARANTEE THAT YOUR RESCUE NEAPOLITAN MASTIFF WILL BE ACCEPTED INTO OUR PROGRAM.  Non-refundable application fees are used as donations to assist us in continuing to rescue and support our rescue dogs.

If you agree to this fee, then please proceed with the Form below.  When you submit the Form you will be re-directed to a PayPal donation page to send in your Surrender Application Fee.