Surrender Form We are dedicated to finding the best possible home for your dog. To do so effectively, we rely on the information you provide us. Please complete the surrender form and upload all or any paperwork from the dog's most recent veterinarian. The dog's vaccinations (Rabies, DHPPL, Bordetellosis) have to be up to date and heartworm test and deworming must to be done). There is a $280 CAD / $280 USD (non-refundable) surrender fee. It is due upon acceptance of the surrender request. Please send the fee using email money transfer to (info@freekoreandogs.org ). Dog Owner's InformationYour Legal Name* First Last Your Email* Enter Email Confirm Email Your Phone*Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Dog's InformationDog's Name*Please write your dog's original Korean name and current name. Dog's Gender* Male Female Dog's Age* Dog's Breed* Dog's Microchip Number* Is your dog's microchip registered under your name?* Yes No Why are you surrendering this dog?*How would you describe this dog's personality most of the time?*Select all that apply. Playful Active Social and friendly Shy with strangers Friendly with strangers Quiet and relaxed Timid Fearful Independent How does this dog interact with other dogs?* Good Indifferent Bad Unknown How does this dog interact with other cats?* Good Indifferent Bad Unknown How does this dog interact with other children?* Good Indifferent Bad Unknown Who is this dog most comfortable with?*Select all that apply. Women Men Kids Seniors Loves all people Which food does this dog eat?* Dry food Dry & wet food Raw food Is this dog housetrained?* Yes No Occasional accidents Use peepads How is this dog in the car?* Good Getting better Bad Unknown Does the dog have any problems in the following areas?*Select all that apply. Chews Protects food/toys Snaps Growls Bites Excessive barking Separation anxiety Chase vehicles/bikes Climbs fences Escapes the yard Digs Jumps up Lunges Pulls on leash Is there anything else you would like us to know about this dog?*When was your dog's last vet wellness visit? (Exact dates will be confirmed with the vet clinic)* Is this dog currently up to date with vaccines?* Yes No Date of last vaccination* Is this dog currently on a flea/tick/heartworm prevention program?*Select all that apply Flea prevention Tick prevention Heartworm prevention Name of the prevention products* Has this dog ever been diagnosed with and/or treated for any medical problems?* Yes No If yes, please explain Veterinary Clinic Name* Veterinary Clinic Phone*Please upload the following photos: Vaccination documents Heartworm test result Receipt of the prevention product(s) Files must be maximum 3 MB each and jpg, png and gif images only. Please be patient as it may take a few moments for the photos to upload.File* Drop files here or Select files Accepted file types: jpg, jpeg, gif, png, Max. file size: 3 MB, Max. files: 8. ConfirmationTerms of Surrender* Select All I hereby surrender ownership of my dog to Free Korean Dogs / Free Korean Dogs US. If Free Korean Dogs accepts my surrender request, I understand the original adoption fee is non-refundable and non-transferable as stated in the adoption agreement I signed with Free Korean Dogs / Free Korean Dogs US. I understand that a surrender fee of $280 CAD / $280 USD (non-refundable) is due upon acceptance of the surrender request. I will follow the safety equipment protocol and Free Korean Dogs / Free Korean Dogs US adoption agreement terms and conditions until the dog is physically removed from my care. I will keep the dog and provide good care until Free Korean Dogs / Free Korean Dogs US finds a foster. Signature*Write your signature inside the box to confirm your surrender request. Share this:Share on FacebookShare on WhatsAppShare on RedditShare on TwitterShare on SMSShare on Email