Southland Sheltie Rescue
SOUTHLAND SHELTIE RESCUE, INC.
ADOPTION APPLICATION
NAME:
________________________ E-Mail___________________
PHONE DAY: _________________ PHONE EVE:
_______________
ADDRESS:
______________________________________________
CITY:___________
STATE: ________ ZIPCODE:
____________
OCCUPATION:
_____________________________________________
1. Why do you want a Sheltie ?
2. Have you ever owned a Sheltie before
?
If yes, please specify sex, color and if you still have the Sheltie ?
3. Do you intend to keep this dog
primarily in or outdoors ?
Please elaborate:
4. Do you have any children ? If so,
what number and ages ?
5. Do you have any other animals ?
Please list what kind and sex.
6. Do you live in a house, condo,
apartment ?
7. Do you have a fenced yard ?
What type of fencing? (ie: brick, wood, chain link)
8. Do all family adults work or is
someone home during the day ?
Please explain:
9. Do you have a sex preference ?
Male Female
10. Would you consider adopting the
opposite sex ? An
older dog ?
To what age ?
Color preference
? Second choice ?
11. Would you be willing to allow a
Sheltie Rescue member to visit your home ?
12. Would you consider adopting a
Sheltie mix ?
13. How did you hear about Sheltie
Rescue ?
14. What size are you interested in ?
(circle one)
Undersize Average Oversize
If you do not have children, do you have
children visit often ?_________
Visit our Website at:
http://members.aol.com/sheltirscu/sheltie.html
Please tell us a little about yourself
so that we can match the right sheltie to your
home and your lifestyle.
__________________________________________________
___________________________________________________
___________________________________________________
____________________________
__________________________
Signature
Date
* Note: If you are under 18 years of
age, please have a parent or guardian sign in addition to your signature
and include a phone number for them.
RETURN TO SHELTIE RESCUE: C/O
Judi Barry
Kathy Parsons
Roz Cohen
911 W. Florence Ave.
261 N.
Marian St.
4430 Nogales Dr.
La Habra, CA. 90631-4536 La
Habra, CA. 90631-4536 Tarzana, CA. 91356
(562) 691-8118
(562) 691-6038
(818) 996-1269
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-
 Central Illinois Sheltie Rescue
1910 Berrywood Lane - Bloomington, Illinois 61704 - 309-663-2440
Adoption Application
Mail this application to: Central
Illinois Sheltie Rescue OR print this application,
fill out, then snail mail to Central Illinois Sheltie Rescue - 1910
Berrywood Lane -
Bloomington, Illinois 61704..... Please note that we
have the right to refuse any applicant.
Cut & paste directions:
(Win95 or 98) Place your mouse pointer anywhere on this page.
Right click one time. (right button on your mouse) choose "select
all".
Then, right click again, and choose "copy". Then open your
e-mail editor,
or a word processing program. When you have the blank document
ready that you want to
paste this into, place your mouse pointer in the blank space, and click your mouse
one
time to make sure the cursor is IN the document.
Then right click again, only this time choose "paste".
Personal Information
Name:
Address:
City
State
Zip
Phones: Home ( )
Work: ( )
Employer:
May we call you at work?
E-mail address:
Do you check e-mail every
day?
**Name of dog(s) you are applying for?
Have you submitted an application with any other
rescue group ?
Why do you want to adopt a rescue sheltie?
___________________________________
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?
Your Home
Who lives in your home?
Please list ages of every person living (even
part-time) in your home:
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?
Do you have a yard for the dog to use?
Is it securely fenced, with no holes or gaps, on all
sides so
that a small animal could not escape?
Describe the material and height of your fence?
Does a door from your house 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?
IF you were to move, what would happen to this dog?
______ I would give the dog back to CISR
______ We would take the dog with us no matter what
______ We would try and find the dog a home
______ Depends on circumstances
** If you don’t have a fence......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 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: _____________________________
Your Present or Previous Pets
Please tell us about your past and present pets;
(continue on back if needed)
Breed? - Sex? - Fixed?
- What happened to pet?
If any of your present or past pets were not spayed
or neutered,
please explain why?
_____________________________________________________
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?
What dog food do you plan on feeding your new Sheltie
?
Name, address and phone number of your Vet:
Please circle one: My vet may or may not be used as a
reference.
How often do your current dogs get groomed?
Who is your groomer?
Daily Schedule
Do all adults in the house work away from
home?
Will any adult 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?
_____ loose in house
_____ outside
_____ crate
_____ X-pen
_____ kitchen
_____ basement
_____ 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 in your home?
Explain:______________________________________
Where will the dog sleep at night?
Are dogs allowed on your furniture?
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, or needs medication) dog?
Would you be willing to work with a "behavior
problem" dog?
Would you be willing to take an older dog?
Up to what age?
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
_____ be very laid back and calm
_____ have lots of energy and exuberance
_____ be totally housetrained
_____ not be shy with strangers
_____ Other: __________________________________
Financial Commitment
Are you aware of the financial responsibilities of
dog ownership….
Including vet care, medications, food, licensing, shots,
grooming…etc?
AKC reports it costs over $1000 per year
to properly care for a dog,
will this fit into your budget?
Will you agree to use only a premium, quality dog
food for your sheltie?
Long Term Commitment
IF your Sheltie was to get loose and run away,
because this breed is so shy.....
it could take $1000's of dollars in posters, ads in newspapers, and rewards, to
find it.
Are you aware of this, and would you go to these lengths?
Check any of the following circumstances that would
cause you to give this dog back to us? (Check all that may apply)
____ a new job (working more, longer hours)
____ kids getting busy, 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 ______________________________
Are you aware that the next step in becoming
approved, is for someone from rescue
to come out and meet with you?
How are you planning on getting this dog to
you? (We don’t ship dogs)
Are you aware of the fees that our rescue
organization charges ?
Puppies up to 1 year old........ minimum donation $
250
Adults 1-9.......... minimum donation $ 180
Senior Adults 10+.......... minimum donation $125
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 Central Illinois Sheltie Rescue.
________________________
Date
______________________________
Signature of applicant
Please check to be sure all questions are answered.
Incomplete applications are not accepted.
Mail to: Central Illinois Sheltie Rescue - 1910
Berrywood Lane - Bloomington, IL - 61704
Please note that we have the right to refuse any
applicant.
Long Island Shetland
Sheepdog Rescue
Application for
Adoption
Long Island Shetland Sheepdog Fanciers (LISSF) Rescue is a
not-for-profit group comprised of volunteers who give of their time, ability and even
their homes to help place Shelties where they will be well cared for and loved. Our main
goals are the protection of Shelties already here, the prevention of further over-breeding
and the education of any Sheltie owner who requests it.
The birth of LISSF Rescue came in response to the need to find
good homes for Shelties that are abandoned lost or mistreated and that are in dire need of
a new lease on life. We also help, in extreme emergencies, those who have to give up their
dogs. We feel that the responsibility for caring for lost, neglected and abused Shelties
must rest with those who know and love the breed. LISSF Rescue is made up of individuals,
some of them current or former breeders, who have many years of experience with this breed
and understand the needs of the dogs. What better reward could there be than knowing that
dozens of Shelties which otherwise might have been put to sleep, left out to starve or to
run loose in the streets to be crippled or killed in traffic, are instead currently in
loving and caring homes!
POINTS TO REMEMBER
- Fees: A minimum of $200.00 is required when you adopt a Sheltie.
Your donation is used to help the continued number of Shelties that come into our Rescue.
Some of these dogs require extra medical care or special rehabilitation, which will entail
much greater expense; we do not require, but would appreciate an extra donation.
- Spaying/Neutering: Any dog adopted from LISSF Rescue will have
been spayed or neutered, because rescued Shelties are not suitable for breeding. Rescued
Shelties make marvelous friends, and placing them in loving, supportive environment is the
only goal we will pursue.
- Contracts: All adopters of Rescue Dogs will be asked to sign an
Adoption Agreement. This contract is legal and binding. Please read it carefully.
- Miscellaneous: We recommend you follow a regular inoculation
program established by your veterinarian to ensure your dog stays healthy. You will
receive a complete medical history on your Sheltie, as best as can be determined or
documented. You must also have the dog licensed in accordance with the laws where you
live. Since we do not know you personally, the information from the Adoption Request
Questionnaire (which is requested of anyone seeking a rescue Sheltie) will help us to
match up the right kind of Sheltie for your family. We place our Shelties only in good,
loving homes, and we screen prospective adopters thoroughly.
Keep this cover information ( page#1) and the
"Terms of Adoption"( page #5) for your reference. Please fill out the attached
form and return it to us as soon as possible.
CONTACT: Long Island Shetland
Sheepdog Fanciers Rescue
29 Milford Place, Rockville Centre,
NY 11570
Phone: (516) 764-6936, e-mail: SayreSS@optonline.net
Web site: http://www.geocities.com/heartland/woods/7224/
** Please answer these
questions carefully as your answers will help us find a good companion for you and your
family**
Name: Date:
Address:
Phone: e-mail:__
_____________________
Occupation: Work Phone:
- Why do you want a Shetland Sheepdog?
- What plans do you have for the dog?
- Why do you want to ADOPT a
"Rescue Sheltie?"
- Have you ever owned a Sheltie Before?
- Where is he/she now?
- Please list all the pets (past and
present)
you have owned in the last 10 years.
Name Breed Sex Age Spay/Neuter How
Acquired Where are they now?
--------- ----------- ---- ----- Y/N
----------------------- ---------------------------------
--------- ----------- ---- ----- Y/N
----------------------- --------------------------------
--------- ----------- ---- ----- Y/N
----------------------- ---------------------------------
--------- ----------- ---- ----- Y/N
----------------------- ---------------------------------
- Have you ever had a pet die at an
early age, run away, hit by a car, bite someone,
given away or die by disease?
Please explain if yes:
- Do you know how to care for your dogs
Nails?_____Ears?_______
Coat? _____Nutrition?______________
_General Health?_________
Please explain:
- How much do you think it will cost to
care for this sheltie each year?
(Remember: Cost of Vet care, Food,
Training, Grooming, Licensing, Etc…)
- Have you ever participated in
obedience training with a dog?
- Who was your trainer? Name:Phone:
- What methods of training were you
taught?__________
- Have you ever housebroken a dog
before? If so, how did you go about it?
- Will you put this adopted sheltie
through obedience training? ______
- Do you understand crate training?
- Would you like information about crate
training?
- Are you planning to use a crate? _
- How many Adults live in your
household?Relationship?_
- How many children?Ages?_____
- What kind of experiences with dogs
have your children had?
- Have any of your children had a bad
experience with a dog? Please explain?
- Are the members of your household
aware that you are adopting a sheltie?___
- Is anyone in your home allergic to any
animals?
- What type of care does a sheltie
require?_________________
- Who will be responsible for the care
of the sheltie?
- Is someone home during the
day?Who?_____
- How many hrs. a day will your sheltie
be alone?
- Where will the sheltie be kept during
the NIGHT?
- During the DAY?
- Who will care for your sheltie when
you are on vacation?
- Are you planning to move in the near
future?If so what will happen to your sheltie?
- Do you live in a
house?Apartment?Other?_________
- Do you rent or own?Do you have
Landlords permission to keep a dog?
- Landlord’s name:Phone#
- Do you have a yard?
- Is it totally enclosed with a fence?
- What type & height is the fence?
- If no fence, how will you exercise
your sheltie?
- Who will supervise the dog while it is
outside?_____
- When exercising your Sheltie, will you
always keep the sheltie on a leash
or in a fenced area at all times?
Why?
- Are you willing to fence in your yard
or an area?
- Will your sheltie be licensed?And wear
an I.D. tag at all times?
- Is the sheltie going to be a gift?For
whom?Do they know?
- All LISSF Rescue shelties will be
spayed or neutered. Do you accept this?
- With an appointment, will you to let a
rescue representative visit your home?_
- How did you hear about LISSF Rescue?
- Do you accept that there will be a
$200.00 minimum donation for the adopted dog,
and agree to pay this donation?
- Are you prepared to assume the financial responsibilities of
caring for an animal, including
vaccines, vet care, good quality food, training, licensing, etc…?
- Are you also willing to make a commitment to take responsibility
for the
sheltie for next 10 years or more?
- Please give us two references( family members not preferred):
Name Phone number Relationship
-
-
- Please give us the name and phone
number of the veterinarian you plan to use:
Name of Animal Hospital? Phone #
Name of Veterinarian?
- How do you know of this
Veterinarian’s reputation?
- Have you used this Veterinarian in the
past?
- Your experience has been?
- If Not, Who are the veterinarians you
DID use in the past?
Name: Phone: Name: Phone:
- Should you become unable to care for
your dog due to health related
issue who will care for your dog?
- If you can no longer care for this
adopted sheltie for ANY
reason do you agree to immediately contact LISSF Rescue? ________________
________________
Requested Shetland Sheepdog
Information:
- Please circle:Quite/ Energetic/
Playful/ Good with dogs, cats, children under 5yrs. old?
- Comments:
- Sex? Age? Color: Sable, Tri Color,
Blue Merle?(1st, 2nd, 3rd choice)
- Would you consider an older dog?
To what age?
- Would you consider a dog with special
circumstances (Medical, Temperament, Etc…)?
- What expectations do you hold for this
sheltie?
- Do you have any special needs or
wants?
"Terms Of
Adoption"
- Return: The adopted dog may be
returned to LISSF Rescue within one week of the date of adoption for full refund of
donation if the adopter is not satisfied with any aspect of the adoption. After one week
from the date of adoption no refund will be given if the dog is returned to LISSF Rescue.
- Transfer of ownership: The adopted dog
may not be transferred to any other person for any reason. If the undersigned adopter is
forced to relinquish custody of the dog at any time, said dog will be given only to LISSF
Rescue.
- Refund: There will be no refund or
reimbursement for any expenses incurred by the adopter for the adopted dog, even if it is
returned to LISSF Rescue.
- Health Program: The adopted dog will
be licensed in accordance with the laws in the jurisdiction in which the dog resides. The
adopted dog must wear an Identification tag at all times. The adopted dog will be cared
for humanely, including good quality food, shelter and water available 24 hrs. a day. The
dog is to be seen by a veterinarian yearly, given all necessary vaccines, checked for
heartworm each spring, stool sample checked for worms every six months and seen by the vet
when ill. THE DOG IS TO BE EXERCISED IN A FENCED YARD OR ON A LEASH AT ALL TIMES AND NOT
FREE TO ROAM.
- Reason for adoption: The adopted dog
is to be kept as a house pet; it shall not be used for medical or any other experimental
purpose; it shall not be chained or tied, and it shall not be used for breeding.
- Loss: If the adopted dog is lost or
stolen, the adopter will notify LISSF Rescue immediately, at least within (2) days, so
LISSF rescue can help locate the adopted dog.
- Reservation of Rights: Long Island
Shetland Sheepdog Fanciers rescue reserves the right to enforce this contract in order to
protect the welfare of the adopted dog. It is understood that LISSF Rescue may examine and
will make inquiry about said dog at any time. If the terms and conditions of the adoption
Agreement are not upheld, LISSF Rescue reserves the right to terminate the Agreement and
to reclaim the dog.
- Return Check Charge: There will be a
$25.00 charge on all returned checks submitted by the adopter.
*Applicants Copy*
Application for
Adoption (Con…)
"Terms Of Adoption" (Con…)
I am in full agreement with the Long
Island Shetland Sheepdog Fanciers Rescue Terms of Adoption. By signing below I am
attesting to the truthfulness of my answers. I understand that falsification of any of the
above information will be grounds to disallow the adoption of a rescue Sheltie and removal
of the adopted dog from my home by the Long Island Shetland Sheepdog Fanciers Rescue..
Date Applicants Signature
Parent or Guardian Signature (Only if
required)
NOTE: If you are under 18 years of age, a parent or guardian must
also sign this application. Thank you for considering a dog from Long Island Shetland
Sheepdog Fanciers Rescue. If you have any questions, or if we can be of assistance, please
do not hesitate to call.
** We reserve the
right to refuse any applicant. **
Please return Package to: LISSF
Rescue
29 Milford Place, Rockville Centre,
NY 11570
Phone: (516) 764-6936,
e-mail: SayreSS@optonline.net
Web site: http://www.geocities.com/heartland/woods/7224/
LISSF Rescue Official
Use Only
Approved: Disapproved: Date:
Staff Member: Tattoo # NDR LISSR
Comments: Microchip
type_________________
Microchip #____________________
Adopted Dog’s, Name: Rescue
Number: Date:
*LISSF Rescue Copy*
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This page was last updated August 22, 2001.
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