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JACKSONVILLE SHELTIE RESCUE
Adoption Application

In order to be considered for adoption, you must:
Be 18 years of age
Have the Knowledge and consent of ALL adults living in your household
Have verifiable identification
Understand we have the right to deny you an adoption
Know ALL dogs will be placed already spayed/neutered

ABOUT YOU
Please fill out ALL fields. If necessary, enter N/A

Name:

Address:

City: State: Zip:

Home Phone#: Cell Phone#: Age:

Employer: Hours you are at work?:

Work Phone #: May we call you at work?: YesNo

ABOUT YOUR HOME
Please fill out ALL fields. If necessary, enter N/A

1. How many people in your home (ie..Mom-Dad-2 kids)?:
2. Do you have children living in your home (even part-time)?: YesNo
3. Please list ages of children:
4. Do all adults in the house work?:
5. Is anyone home during the day? If so, who and what hours?:
6. Do you live in a : House, Condo, Apartment or other?:
7. Do you own or rent?: Own Rent
8. If renting, what is the name and phone number of your Landlord?:
9. Do you have a fenced yard?: YesNo
If not, how will the dog be excercised?:

MORE ABOUT YOU!
Please fill out ALL fields. If necessary, enter N/A

10. Have you placed an application with any other Rescue group?: YesNo
   If yes, who?:

11. Do you currently have any other animals?: YesNo
   If yes, please list: type, age & sex and if they are spayed/neutered:

12. Are (or were) your pets current on Hearworm prevention? (required): YesNo
   What type of Heartworm prevention do/did you use?:

13. What type/brand of dog food do you intend to use?:

14. How many pets have you owned in the last 10 years?:
       What happened to each of them?:

15.    Do you currently have a Veterinarian?: YesNo
         Name of Vet: Vet Phone #:

LETS TALK DOGS!
Please fill out ALL fields. If necessary, enter N/A

16. Have you ever owned a Sheltie before?: YesNo
17. Why do you want a Sheltie?:
18. Are you aware that Shelties are "barkers"?:
19. Are you aware of all a Shelties needs? (i.e. grooming, exercise):
20. Are you aware that Shelties may be shy around new people, and may take awhile to bond with?:
21. What role will this animal have? (ie.. pet, watchdog, breeding):
22. Do you intend to keep this dog primarily indoors or outdoors?:
23. Where will this dog stay during the day, while you are at work:
24. Where will the dog sleep?:

MORE DOGS!
Please fill out ALL fields. If necessary, enter N/A

25. Do you have the time and or patience to housetrain a dog?:
26. Would you be willing to take a "special needs" (blind, deaf, sick) dog?:
27. Would you be willing to work with a "behavior problem" dog?:
28. Would you be willing to take a much older, more needy dog?:
29. Do you have a color preference?:
30. Do you have a sex preference?:
31. Do you have an age preference?:
32. Do you have a size preference?:
33. Are you aware of the financial responsibilities of dog ownership (including vet care, medications, food, licensing, shots,
grooming, etc.) and that total expenses of owning this dog could be $1,500 per year?:
34. Would this dog be a priority in your life?:
35. What circumstances, in your opinion, would justify you getting rid of this dog?:
36. Are you aware of the fees that our rescue organization charges? Most adoption fees are $200.00:
37. Are you willing to have a member of Sheltie Rescue visit your home prior to adoption and after the adoption?:

(optional)

Do you have any personal comments that you would like to make?

VERIFICATION
(required)

   Name Of Closest Relative not living with you: Relationship:
     Relative's Address: City: State: Zip:
     Telephone of Relative:

Your Email Address: Confirm Email:

All of the answers I have given, are true and correct to the best of my knowledge.

Signature of applicant: Date:

It may take several seconds to process your application.
Please be patient and do not press the Submit button more than once.
Thank you for your interest in Sheltie Rescue!