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*
Do you have small children, or 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*
Terms of Adoption A person adopting a dog from Sheltie Rescue must agree to pay: $300.00 adoption fee for a dog 18 months or younger (non-refundable) $250.00 adoption fee for a dog over 18 months of age and up to 9 yrs. old. (non-refundable) $75.00 adoption fee for a dog over 10 years of age (non-refundable) Costs for any medical care or medication needed currently and in the future. Vaccination costs. Yearly heartworm test and preventative. In addition, the adoptee must agree to keep the dog in good condition by providing an adequate and nutritious diet, fresh water, regular exercise, suitable housing, a protected area when outdoors, regular physical examinations, prescribed medications, routine grooming and loving companionship. If for any reason, the adoptee cannot keep the Sheltie, Sheltie Rescue shall be notified and the dog and full-ownership will revert to Sheltie Rescue. The adoptee must understand that SRCI has made no promises or representations concerning the temperament of this Sheltie or its fitness as a pet or for any other purpose. Further, I understand that SRCI or any individual member will not be responsible for any problems or injuries caused by this Sheltie. If this dog is lost or stolen, SRCI will be notified immediately so that they can help locate the dog. If the terms of this contract are broken, SRCI reserves the right to reclaim the dog. I am in full agreement with Sheltie Rescue Terms of Adoption and am willing to pay the appropriate adoption fee (non-refundable). 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 Sheltie Rescue. If you have any questions, or if we can be of any assistance, please do not hesitate to call. SRCI reserves the right to refuse any applicant. Please type your name in the box below to acknowledge reading and accepting the terms above. *
