We are working on an online application form, For now though, please use the format below to enter your responses in a text editor or you can also print, complete and scan the application. EMail it to our application coordinator at
Northeast Ohio Shetland Sheepdog Inc Adoption application
Name:
Address:
City: State: Zip Code:
Phone: Home ( ) Work ( )
Occupation/Employer:
May we call you at work?
Email Address:
Do you check Email every day?
How long have you lived at your current address: ______________If less than two years, then list your previous address:
______________________________________________________________________
Type of residence: House __________ Apartment __________ Mobile home________ Condo __________
Do you: Own _____ Rent _____ If renting, do you have permission to have pets?
____________________
Does the place you live have any restrictions as to the size, weight, or number of dogs you are allowed to own? ___________
Landlord’s name: _____________________ Phone ( ) __________________
Number of children in home: ___________ Ages: _________________________
Are there others besides your immediate family residing in your home? __________
If Yes, who? __________________________________________________
Does your home have a yard? _________ Is the yard entirely fenced? _____________
What type of fence and how tall is it? __________________________If you do not have
a fence, how do you plan to confine the sheltie to your property?
_______________________________________________________
Have you had pets in the last five years? _________________
What kind? __________________________
What happened to those pets? ___________________________________________
Were they spay/neutered: __________ If not, why? __________________________
Do you intend to keep the sheltie indoors or outdoors? Please elaborate!
____________________________________________________________________
____________________________________________________________________
Where will your dog be kept while you are away from home (Crate, Baby gated in room, Full run of house, outside in fenced area, etc.)
_________________________________________________________________
What is the longest period or time your dog may be left alone?
_________________________________________________________
Who will care for your pet(s) if you go away on vacation?
_________________________________________________________
Will your dog be permitted on your furniture? _________________
In your bed? _____________________
Will you take your new dog to obedience class if needed? _______________
List any reason(s) that would cause you to “give up” your Sheltie: (Divorce, Move, Baby, Allergies, etc.) ________________________________________________________
____________________________________________________________________
Since most of these dogs have unknown medical backgrounds, are you willing and prepared to provide any needed medical treatment? ___________________
Would cost be a factor? ______________________
Current veterinarian’s name
_________________________________________________________________
Address: __________________________________________________
City: ____________________________ State: ______________ Zip: ____________
Phone: ( )____________________
How long have you been a client? ___________________
Do you have a sex preference for a Sheltie? Male: __________ Female: __________
No preference: ____________
Do you have a color preference? _____________
If yes, what color? ________________________________
What is the oldest age Sheltie you would consider? _____________ Would you consider a “special needs” Sheltie? (Deaf, Blind, Behavioral problems, Medical issues, etc.)
_________________________________________________________________
Why do you want a Sheltie? ___________________________________________
Are you willing to allow a rescue representative to visit your home by appointment before and after the adoption? _______________ If not, please explain why:
_________________________________________________________________
PLEASE READ AND INITIAL EACH STATEMENT BELOW
I certify that the information I have provided on this form is true and correct
____________
I am financially able to provide the Sheltie with the proper food and veterinary care, which may be costly. (National average expenses for a dog is estimated to be $600.00 or more annually)
_____________
I understand that any false statements constitute grounds for confiscation/surrender of the Sheltie back to the rescue upon demand.
_____________
I agree that if the adoption is unsuccessful that I will contact the rescue immediately and return the Sheltie to them.
______________
Under no circumstances will I place this Sheltie with another person, organization, relative, or anyone else other than the rescue or their authorized representative.
______________
I further understand that the rescue may demand return of this Sheltie for any violation of the terms of the adoption contract.
______________
We reserve the right to refuse any application
Adoption donations:
$250 Less than one year
$200 Adult Sheltie
$100 Senior, Special needs, etc. May be adjusted at discretion of NEOSSR representative