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