ADOPTION  FOSTER

PERSONAL INFORMATION

Today's Date:                

Your Name (First & Last):

Date of Birth:                 

Address:                       

City:  State:  Zip:

Home Phone:                

Work Phone:                 

Cell Phone:                   

Employer:                     

May we call you at work? Select One Yes No

Email Address:              

Do you check your email every day? Select One Yes No

Name of dog(s) you are applying for?

Have you submitted an application with any other rescue group? Select One No Yes

Why do you want to adopt a rescue sheltie? (Please explain)

YOUR PREFERENCES

Do you have a time and/or patience to housetrain a dog, if it is not already trained? Select One Yes No

Would you be willing to take a "Special Needs" (scared, shy, handicapped, or need medication) dog? Select One Yes No Possibly

Would you be willing to work with a "behavior problem" dog? Select One Yes No Possibly

Do you have a age preference? Select One No Preference 8 weeks to 4 months 4 months to 1 year 1 year to 3 years 3 years to 9 years Senior (9 years and older)

Would you be willing to take an older dog? Select One Yes No Possibly    Up to what Age?

Do you have a color preference? Select One No Preference Tri-Color Sable Blue Merle

Do you have a size preference? Select One No Preference Standard Size (13" to 16") Smaller than Standard Larger than Standard

Do you have a sex preference? Select One No Preference Male Female

Will you take the opposite sex? Select One Yes No

Do you have a personality preference, ie: Couch Potato, Frisbee Dog, Jogging Partner, Quiet Companion, Senior, etc.? Please Explain:

Please put the following in order of importance to you: 1 being the most important, 11 the least important.

I want my new Sheltie to:

Other (Please Explain):

SHELTIE HABITS

Have you ever owned a Sheltie before? Select One Yes No

Are you aware of all a Shelties needs and habits? (i.e. regular grooming, exercise) Select One Yes No

Are you aware that Shelties are "barkers"? (doorbell, phone, UPS man, mailman, strangers, etc.) Select One Yes No

Are you aware that a Sheltie is a longhaired, double-coated breed, one that will shed? Select One Yes No

Are you aware that Shelties may be somewhat shy around new people, and may take a while for bonding to take place? Select One Yes No

Are you also aware that because of their reserved nature, Shelties are a high runaway risk during the first month or more? Select One Yes No

Your Current and/or Previous Pets

Tell us about your present and past pets:

Do you currently have any pets (dogs, cats, birds, reptiles, etc.) at home? Select One Yes No

If YES, please describe below:

Have you had any pets (dogs, cats, birds, reptiles, etc.) in the past? Select One Yes No

If YES, please describe below:

If any of your present or past pets are/were not spayed or neutered, please explain why:

Will you agree to keep all of your current pets, and your new Sheltie, up to date on all of the following:

Vaccinations? Select One Yes No   Heartworm Prevention? Select One Yes No What Brand?

Flea Prevention? Select One Yes No What Brand?

Licensed in your County? Select One Yes No

What dog food do you plan on feeding your new Sheltie?

Your Current Veterinarian Information:

Vet or Clinic's Name:   Phone Number:

Address:

City:  State: Zip:

My vet may be used as a reference: Select One Yes No   If NO, please explain:

How often do/did your dogs get groomed?

Who is your groomer?  Groomer's Phone Number:

Your Home:

Who lives in your home?

What are the ages? Important - List the age of every person living (even part-time) in your home:

What are the ages of frequent visitors, if they are minors, and how often?

What is the speed limit of the road you live on?

Type of home you live in: Select One House Condo-Townhouse Apartment Duplex Mobile Home Other

If other, please explain:

How long have you lived there?

Do you own or rent? Select One Own Rent

If renting, does your landlord allow pets? Select One Yes No

Your Landlord's Name and Phone Number:

Do you have a yard for the dog to use? Select One Yes No

Is your yard fenced, with no holes or gaps, on all sides, so that a small animal could not escape? Select One Yes No Not Yet, working on it

Describe the material and height of your fence?

**If you do not have a fence, please select one of the following:

I will walk it on a leash.

I plan on training this dog to stay in my yard.

I have a "tie-out" trolley or stake.

Other: Please explain

How will you allow this dog to run and get exercise?

I will walk it on a leash for miles every day.

I will take it to a large park or field nearby.

I have a large yard to dog can run in.

Other: Please Explain

Does a door from your house open directly into the fenced yard? Select One Yes No

How will your dog access the area for relieving himself?

Do you have a swimming pool? Select One Yes No

If YES, is it   Above Ground  Built-In  

If YES, is it fenced in? Select One Yes No How tall is the fencing? What kind of fencing is it?

Does your home have any steps and/or stairs? Select One Yes No    If so, please describe:

Are you planning a move in the foreseeable future? Select One Yes No

If you were to move, would you insist on a new house having a fenced yard? Select One Yes No

IF you were to move, what would happen to this dog? Select One I would give the dog back to Sheltie Rescue I would try and find the dog a home I would take the dog with us no matter what Depends on circumstances

Daily Schedule

Do all adults in the home work away from home? Select One Yes No

Will any adults be home during the day with the dog? Select One Yes No

Specifically, how many hours will this dog be home alone daily?

Where will this dog stay while home alone? Select One Loose in house Crate in the house X-Pen Kitchen Basement Outside Outdoor dog kennel Other (explain)

If other, please explain:

Please check all that apply in your home:

Busy household - visits by friends, children, parties

Noisy - TV, stereo, machinery, tools, children playing

Moderate - normal comings and goings

Quiet - "homebodies", few guests, stay home a lot

Lots of children in the neighborhood

Live on busy street or highway

Where will this dog spend most of its time? Select One Outside Inside Outside and in garage Outside during the day and inside at night

Are dogs allowed in all rooms in your home? Explain:

Where will the dog sleep at night?

Are dogs allowed on your furniture? Select One Yes No

Financial Commitment

Are you aware of the financial responsibility of dog ownership, including vet care, medications, food, licensing, shots, grooming, etc.?Yes  No

AKC reports it costs over $1,000 per year to properly care for a dog.  Will this fit into your budget? Yes  No  Not Sure

Will you agree to use only a premium, quality dog food for your Sheltie? Yes  No

Long Term Commitment

If your Sheltie were to get loose and run away, would you be prepared to spend money for posters, ads in newspapers, and rewards, to find it?  Would you go to these lengths? Yes  No  Probably  Depends on Circumstances

Check any of the following circumstances that would cause you to give this dog back to us.  (Check all that may apply)

A new job (working more, longer hours)

Kids getting busy, no time for dog

Divorce

Moving to a new house

New Baby

Dog needed expensive vet care

Bad habits (potty accidents, chewing, destruction, excessive barking)

Dog bit someone

Other, please explain:

Are you aware that the process of becoming approved may involve someone from rescue coming out to meet with you and do a home check? Select One Yes No

How are you planning on getting this dog to you? (We don't ship dogs) Please explain:

All of the answers I have given are true and correct to the best of my knowledge. I also understand that if any of my answers are shown to be false at a later time, the adoption contract will become null and void, and I will immediately return the dog back to NorCal Sheltie Rescue.

By submitting this application electronically, this will be considered as to represent your signature. (You may be asked to sign a hard copy at a later date)