First Name*
Last Name*
Address*
City*
State/Province*
Zip/Postal Code* -
Email*
Home Phone*
Work Phone x
Cell Phone
I certify that the information entered on this applicant is true. Enter your name and date*
Have you applied with any other rescue* Choose one: Yes No
Why are you interested in adopting a pet at this time*
Have you ever owned a Shetland Sheepdog before? If so, how long?
Do you own any other animals? What kind (type, age and sex)?
How many people reside in your household and what are their ages?*
Do small children visit your home frequently?*
Do you own or rent your home* Choose one: Rent Own
If you rent, have you received the approval of your landlord to have an animal Choose one: Yes No
If you rent, please enter your landlord's name and phone number
Does your home have stairs?*
Where will the animal be kept when you are home*
Who in the household will care for the pet*
Will the animal be kept inside or outside* Choose one: Inside Only Outside Only Inside and Outside
How much time will the animal spend alone during the day*
Is your yard fenced* Choose one: No Yard Unfenced Yard Yard Partially Fenced Yard Completely Fenced
What is the height of the fence*
What type of fence Choose one: Privacy Chain Link Invisible
What traits are you looking for in a pet
Are you willing to have a member of Sheltie Rescue of Central Indiana (SRCI) come to your home to perform an inspection (confirm household, fence, stairs, etc.)?*
Have you ever given up a pet? If yes, please explain
How did you hear about us*
List at least one reference (who is not a family member) along with their phone number.*
Veterinarian's Name and Phone Number*
