If this describes you, then please continue below.

Privacy Note: This information is for private use by Michigan Sheltie Rescue and will never be made public.

 1) Personal Information

I have read the "Adoption Information Page AND "Is a sheltie the right dog for you"?    Yes No

Name:
Current Address:
Address:
City State Zip
Phones: Home (     )                                             Cell: (        )

Other Address: Summer Home, Vacation home etc etc
Address:
City State Zip

E-mail address:
Do you check e-mail every day?

Employer Name:
Address:
City State Zip
Length of time at this job:
May we call you at work?

What days and hours do you work?

Your date of birth: (mm/dd/yyyy)

**Name of dog(s) you are applying for?

Have you submitted an application with any other rescue group ?

               Which group?
               What is the status of that application?

Please tell us which statement describes you best:

____ I want to adopt a Sheltie that has special needs. I really enjoy helping the needy dogs.
____ I want to save a Sheltie's life by adopting a Sheltie that no one else may want.
____ I am only interested in adopting a young, healthy, well-mannered Sheltie.
____ I will adopt the Sheltie that needs me the most.
____ I want to adopt a playmate for my other dog or children 

Why do you want to adopt a rescue sheltie?

______________________________________________________________________________

2) Sheltie Habits

Have you ever owned a Sheltie before?

Are you aware of all a Shelties needs and habits? (i.e. regular grooming, exercise)

Are you aware that Shelties are "barkers"? (doorbell, UPS man, mailman, strangers etc etc)

Are you aware that a Sheltie is a longhaired, double-coated breed, that WILL SHED?

Are you aware that Shelties may be somewhat shy around new people, and may take awhile to bond with?

Are you aware that because of their shyness, Shelties are a high runaway risk during the first month?

3) Your Home

Who lives in your home?

Please list ages of every person living (even part-time) in your home:

Do you EVER have small/young children in your home or yard? How Often?

Explain:

Are you aware that most Shelties are NOT good with small children?

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

Do you live in a: (circle one) House Apartment Condo Other

Do you own or rent?
If renting, does the landlord allow pets?

What will you do with this dog when you move, if new home does not allow pets?
 

Where will this dog be allowed to play and eliminate/potty ? Front yard? Back yard? Both?

 

Is your yard securely fenced, with a physical fence, with no holes or gaps, on all sides, so that a small animal could not escape?

Describe the material and height of your fence?

***IF your fence has pickets with a space between pickets, please tell us how many inches wide the space between the pickets is.  (Please measure and be accurate)

Have you ever completed an obedience class or other formal training with your prior dogs(s)?

Have you ever successfully trained any prior dogs to stay with you, and under your control without a fence or leash?

Have you ever had a dog escape from you, and be gone for any length of  time?
         Please explain how you handled it?

Does a door from your house (not garage) open directly into the fenced yard?

Are you planning a move in the foreseeable future?

If you were to move, would you insist on a new house having a fenced yard prior to moving in?

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

Do you have a lot of stairs in your home this dog will need to use?

Does the exit from your house into the backyard involve using stairs?
Explain:

 ** If you don’t have a securely fenced yard......complete this section:

How will this dog be allowed to relieve itself daily?

_____ I will walk it on leash
_____ I plan on training this dog to stay in my yard
_____ I have a "tie-out" trolley or stake.
_____ Other explain: _______________________________

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

_____ I plan on training this dog to stay in my yard
_____ I will walk it on a leash for _____ miles every day.
_____ I have a large yard the dog can run in.
_____ There is a large park or field nearby.
_____ Other: _____________________________

4) Your Pets

Please tell us about your past and present pets. Be specific please.

Breed? - Sex? - Fixed? - Dates owned –Ages you owned pet- - What happened to pet?

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

 

Have you ever had to re-home a pet?                   Explain?

Have you ever had a pet stolen or lost?                Explain?

Have you ever had a pet hit by a car?                   Explain?

Will you agree to keep all of your current pets and your new Sheltie:

· Up to date on all shots?
· On heartworm prevention medication?
· What brand? ___________________
· On flea prevention medication?
· What brand? __________________
· Licensed in your county?

Name, address and phone number of your Veterinarian: (please make sure this info is correct)

Do you grant us permission to contact your Vet to verify the quality of Vet care you give?

How often do your current dogs get groomed?

Who is your groomer?
 

5) Your Dog Care Knowledge
 

What are heartworms?

Are they preventable?                   How?

 

Are you aware that Shelties (as a breed) have high maintenance teeth and will need dental cleanings by your vet frequently? (possibly yearly)

What symptoms would you likely notice if your dog had a decayed or infected tooth?

What symptoms would you likely see if your dog had worms?

What symptoms would you likely notice if your dog had an ear infection?

What is one of the first signs of illness in a dog?

IF you have a gut feeling that something is wrong with your dog, but your Vet doesn't seem concerned  what would you do?
 

What type/brand of food do you feed your current dog?            
What food do you plan on feeding new dog?

6) Daily Schedule

Do all adults in the house work away from home?

Will any owner of the dog be home during the day with the dog?

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

Where will this dog stay while home alone?

_____ confined to one or more rooms
_____ loose in house
_____ loose in house with doggie door to yard
_____ outside
_____ crate
_____ X-pen
_____ kitchen
_____ basement
_____ garage with door to yard
_____ other: 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?

______ outside
______ inside
______ outside during the day and inside at night
______ outside and in garage

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

Where will the dog sleep at night?

Are dogs allowed on your furniture?

7) Your preferences

Do you have the time and or patience to housetrain a dog, if it is not already trained?

Would you be willing to take a "special needs" (scared, shy, handicapped) dog?

Would you be willing to take a dog with an illness or disease that is manageable?

Would you be willing to work/train a dog with some bad manners?

Would you be willing to take a senior/older dog?

Do you have a color preference?

Do you have a sex preference ?
             Will you take the opposite sex?

Do you have an age preference?

Do you have a size preference?

Do you have a personality preference? (ie…Couch potato, Frisbee dog, jogging partner, quiet companion, etc.)

Explain:_____________________________________________________________________________

Please put the following in order of importance to you:

I want my new sheltie to:

_____ play with my other dog
_____ play with my children
_____ go walking or running with me
_____ be affectionate and cuddly
_____ be a good watch dog
_____ become a performance dog (agility or flyball)
_____ be trained and shown in obedience
_____ be very laid back and calm
_____ have lots of energy and exuberance
_____ be totally housetrained
_____ not be shy with strangers
_____ Other: __________________________________

Is there any quality in a Sheltie that you do NOT want ???

8) Your Commitment Level

Are you aware of the financial responsibilities of dog ownership….(vet care, medications, food, licensing, shots, grooming…etc?)

AKC reports it costs on average $1000per year to properly care for a dog, will this fit into your budget?

*Are you aware that Shelties need yearly dental cleanings that cost $80-$400?

*Are you aware that many surgeries for a dog can run into the thousands of dollars per surgery?

*Are you able to meet these Veterinary financial needs?

Are you aware that ALL dogs, just like people, WILL sometime in their life need surgery, blood tests, medications and other medical procedures that can be costly ?

Is there any reason that you would choose not to give expensive care to your dog if it needed it??

Are you aware of the benefits of using a premium quality dog food (all natural, no grain) for your sheltie ?                                      

 Please list 2 of the benefits:


IF your Sheltie were to get loose and run away, because this breed is so shy..... it could take $1000s of dollars in posters, ads in newspapers, and rewards, to find it.

Were  you aware of this, and will you agree to follow our guidelines if this should happen ?
Explain:

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

____ a new job (working more, longer hours)
____ no time for
____ divorce
____ moving to a new house
____ new baby
____ if the dog needed expensive vet care
____ bad habits (potty accidents, chewing, destruction)
____ if it bit someone
____ other (please ______________________________


Please list the name, address and phone of 2 family members who do not live with you.

1)

2)

9) Fees

Are you aware of the fees that our rescue organization charges ?

Puppies to 2 years    $350
Adults 2-9 years old  $300
Seniors 9+          Depends on the dog

Your adoption fee allows us to provide the following services to all dogs in our program

·         Spay or neuter

·         Rabies Shot

·         DH2PP (Distemper/Parvo combo shot)

·         Heartworm Test (and treatment if positive)

·         Heartworm Prevention

·         Flea prevention treatment

·         Wormed

·         Groomed

·         Dental cleaning (if needed)

·         Treatment of any medical issue

·         Blood workup if indicated.

·         Microchip and registration form

·         A medical history record comes with each dog.

Are you aware that the next step in becoming approved, is for someone from rescue to come out and meet with you and your family?

How are you planning on getting this dog to you? (We don’t ship our dogs)
 

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, that the adoption contract will become null and void, and I will immediately return the Sheltie to Michigan Sheltie Rescue.

________________________________                _____________________________

         Signature of applicant                                                   Date

Please check to be sure all questions are answered. Incomplete applications are not accepted.

Please note that we have the right to refuse any applicant.

Email this completed application to: Michigan Sheltie Rescue