Name______________________________email_____________________________________
Address__________________________________________________________
City:___________________________State:_______Zip:___________ Home Phone___________________
Occupation__________________________Work Phone__________________________________________
If apartment, what floor do you live on?__________________________________________
1. Have you previously filed an application with us? YES NO
If yes, give date(s):_____________________________
1a. Have you ever filed an application with another rescue group or shelter (including SPCA,
Operation Kindness)? YES NO
If yes, please list names and dates:________________________________________
___________________________________________________________________________
___________________________________________________________________________
2. Why do you want a Shetland Sheepdog? ________________________________________
___________________________________________________________________________
___________________________________________________________________________
3. Have you ever owned a Sheltie before? YES NO
Do you still have that dog?
Male Female Age_________
Is your pet Spayed or Neutered? YES NO
4. What happened to your last dog?________________________________________
What kind of dog was it? ________________________________________
Please explain the circumstances:________________________________________
5. During the last two years, have you?
Lost a pet (not through death)? YES NO
If "yes," what happened? ________________________________________
Had a pet stolen? YES NO
If "yes," what happened? ________________________________________
Had a pet poisoned? YES NO
If "yes," what happened? ________________________________________
Had a pet killed by a vehicle? YES NO
If "yes," what happened? ________________________________________
Had a pet die due to disease? YES NO
If "yes," what did it die of? ________________________________________
6. For what purpose do you want this dog?________________________________________
___________________________________________________________________________
7. Do you have any other animals? YES NO
List type, age, and sex: ________________________________________
___________________________________________________________________________
Are they spayed/neutered? YES NO
If your animals are not spayed/neutered, please explain:________________________________________________________________
________________________________________________________________
What type of heartworm and flea prevention do you use? ________________________________________
If "none," please explain: ________________________________________________________________
8. What is your vet's name, address & phone number?________________________________________________________________
May we contact the clinic for references?YES NO
9. Do you live in a house_____ Apartment_____Condo_____Mobile Home_____
If an apartment, please provide name of apartment complex and management office number
(for general verification purposes, e.g., weight limits):
________________________________________________________________
10. Do you have a yard?_______Is it fenced?_____If "yes," what type? Height_________
If you do not have a yard/fence, how do you plan to potty/exercise your Sheltie?
________________________________________________________________
11. Do you have a doggie door? YES NO
If "yes," where is the doggie door? (E.g., from house to yard, from garage to yard, etc.)
________________________________________________________________
12. Do you have a pool? YES NO
Above ground or in-ground?
Is it fenced separately from the yard? YES NO
13. Do you RENT OWN?
14. If you rent, do you have the landlord's permission to keep a dog? YES NO
Paid pet deposit? YES NO
15. Are you planning to move in the near future? YES NO
16. Is someone home during the day? YES NO
Please explain: ________________________________________________________________
17. Is someone home during the day? __________Please explain:
________________________________________________________________
________________________________________________________________
17a. What provisions will be made for your Sheltie if nobody is home during the day?
________________________________________________________________
________________________________________________________________
18. Where will the Sheltie spend his or her time while you are gone (please be specific)?
________________________________________________________________
________________________________________________________________
19. Do you intend to keep this dog primarily indoors or outdoors? YES NO
Please explain: ________________________________________________________________
________________________________________________________________
20. Where will your Sheltie sleep? ________________Permitted on furniture or bed?_________________________
21. Do you have a sex preference? MALE FEMALE
If yes, which? _______________________________________________
Would you consider the opposite sex? YES NO
22. Color preference (due to the popularity of Blue Merles, we do not see them often in Rescue)
Second color preference: ________________________________________________________________
23. Age preference (we rarely see Shelties younger than 2 years in our program)
Would you consider: An older dog? YES NO
To What Age?____________ A Sheltie-mix? YES NO
24. What size Sheltie do you prefer?________________________________________________________________
25. Are other members of your household aware that you are considering adopting a pet?
YES NO
List all individuals residing in your household who will be interacting with the
Sheltie (if any individuals are younger than 18 years old, please provide their age and sex)
________________________________________________________________
________________________________________________________________
________________________________________________________________
26. Is anyone in your household allergic to animals? YES NO
27. Are you prepared to assume the financial responsibilities of caring for an animal,
including inoculations, veterinary care, good quality food, licensing, etc.? YES NO
28. Do you understand that the Sheltie you adopt must be kept on monthly heartworm and
flea preventative? YES NO
29. Are you familiar with the animal control regulations in your area?
(including number of pets you are permitted to have in your city)? YES NO
30. Is this Sheltie going to be a gift? YES NO
For whom? ________________________________________________________________
Do they know they are getting the gift? YES NO
31. Do you understand that any rescue Sheltie that you may adopt through DFW Sheltie Rescue
will be spayed/neutered? YES NO
32. What circumstances, in your mind, justify getting rid of a dog?
________________________________________________________________
________________________________________________________________
________________________________________________________________
33. Are you willing to allow a DFW Sheltie Rescue representative member to visit your home
by appointment? YES NO
34. How did you hear about DFW Sheltie Rescue?
__________________________________________________
35. Do you understand that there is a $150 adoption fee for the dog?
YES NO
By signing below, I am attesting that I completed this application and that the information in it is true
and complete. I authorize investigation of all statements contained in this application. I understand
that any misstatement, omission, falsification, or misrepresentation in this application may disqualify
me from adopting a rescue dog or result in the termination of an Adoption Agreement if one is signed.
I have read and understand the Dallas/Ft. Worth Sheltie Rescue, Inc. Adoption Information and Application,
including the (a) Points to Remember and (b) Summary of Adoption Terms and Conditions. If I am approved
to adopt a rescue dog, I agree to sign an Adoption Agreement and to abide by all of the terms and conditions
contained in the agreement.
I understand that the use of this application form does not indicate that a rescue dog that matches me or
my family is currently in the rescue program and in no way obligates Dallas/Ft. Worth Sheltie Rescue, Inc.
("DFW Sheltie Rescue"), to place a rescue dog with me. I also understand that DFW Sheltie Rescue reserves
the right to refuse any application.
I am 18 years of age or older. I have read and fully understand the above statements and conditions of
adoption.
Date:_________________Signature of Applicant___________________________________________
Date:_________________Signature of Co-Applicant (if any) or Parent or Guardian if Applicant
is under 18 years of age_________________________________________________________________
Thank you for considering a dog from DFW Sheltie Rescue. If you have any questions, or if we
can be of assistance, call us at 972.994.7848.
Please return by mail or fax to:
Dallas/Ft. Worth Sheltie Rescue
P.O. Box 251
Merit, TX 75458
903-776-2541
(8:00 a.m. - 9:00 p.m.)
DFW Sheltie Rescue Official Use Only:
Approved Not Approved
Rescue Volunteer:______________________________Date:______________________
Comments:_________________________________________________________________________
___________________________________________________________________________________
Dog Adopted:_____________________________ Number:__________________Date:___________