DATE:_____________  BREED:________________________________________________

SHELTER NAME:____________________________________  TOWN:__________________

SHELTER CONTACT:_________________________________  PHONE:_________________	

STRAY: Y/N  OWNER TURN-IN: Y/N  AGE:__  SEX:__  ALTERED: Y/N  COLOR:______



OWNER TURN IN

DATE:________  AKC PAPERS: Y/N  AKC#____________  HOUSEBROKEN:Y/N  BARKER: Y/N	

GOOD WITH CHILDREN: Y/N  AGES:____________  DOG AGGRESSIVE: Y/N  DIGS: Y/N	

GOOD WITH OTHER ANIMALS:____________________  NAME:_______________________

REASON FOR TURN IN:_______________________________________________________

SHOT RECORD:______________________________________________________________

OTHER COMMENTS.



STRAY

LOCATION FOUND:___________________________________  I.D.TAGS:_____________	

CONDITION OF DOG:_________________________________________________________

OTHER COMMENTS:___________________________________________________________



COSTS

SHELTER RELEASE:          SHOTS:          SPAY/NEUTER:

OTHER MEDICAL:          OTHER:          TOTAL COST:

__________________________________________________________________________

DISPOSITION OF DOG: