First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

Email*

Home Phone

Cell Phone*

Which dog(s) are you interested in?
Choose an animal: Austin Austin the Carebear Honeydew Remy Rio Romeo Skye (Collie puppy) Wilson

The reason I am interested in adopting a Collie or Sheltie is

Have you ever owned a dog before? *

Have you ever owned or fostered a Collie or Sheltie before?

Do you have any pets now?

- If so, what are they? How old? Are they spayed or neutered?

Have you ever been involved in obedience, agility, herding, or other organized dog activities? Do you plan to be?

Have you ever adopted a pet from a shelter/rescue group before?

How many adults live in your home (over 18)?
Choose one: 1 2 3 4 5 6 7 8 9 10 more..

How many children live in your home?
Choose one: 1 2 3 4 5 6 7 8 9 10 more..

Tell us about your family?

Is everyone in your family enthusiastic about adopting/fostering a rescued Collie or Sheltie?

Is anyone in your home allergic to animals?

- If Yes (please explain)

Do you own or rent your home?

- If you rent does your landlord approve of your adopting a Sheltie or Collie? Yes No

- If renting, please provide name/address/phone# of your landlord:

Is your property fenced?

-- If Yes, please describe your fence type and height? (block, chain link, wood)

How big is your yard?
Choose one: Very Large: 10,000 + Square Feet Large: 5,000 - 10,1000 Square Feet Medium: 1,000 - 5,000 Square Feet Small: 500 - 1,000 Square Feet Very Small: Less than 500 Square Feet

Can children open your gates?

Can a dog dig under or jump over your fence?

What style of home do you live in?

Will your dog live inside? Outside? Or both?

Do you have a doghouse or kennel?

Will you use a chain, tie-out or cable runner to restrain your dog outside?

Do you have a doggie door?

Where will your dog sleep at night?

How will you exercise your dog?

During the day, where do your dog(s) typically stay?

How many hours a day are your dog(s) home alone, and where do they stay during that time?

What brand of dog food do you use?

- Are you satisfied with the quality?

Would you welcome advice about other foods for your Collie or Sheltie?

Who will care for your dog when you travel out of town?

Has any member of your household ever been charged with cruelty to animals?

How would you react if your dog destroyed a household object or soiled in the house?

. Are you aware that dogs need regular veterinarian care, especially as they age, which includes annual examinations, necessary vaccinations, worming when necessary, heartworm tests and heartworm preventative, as well as other care directed by my veterinarian?

- Are you willing and able to provide that care?

Do you currently use a veterinarian for your pet health care needs?

How long have you been going to this clinic?

Please provide your veterinarian's name and contact information:

I prefer the following breed:

I would prefer the following gender:

I prefer the following color(s):

What age dog would work best for you?

How much energy should your dog have?

I understand that Collies and Shelties require grooming?

I understand that Collies and Shelties can sometimes be barkers?

Would you consider a dog with special needs, such as deafness, blindness, behavior problems, health problems, or old age?

Please tell us a little about yourself so that we can match the right Collie or Sheltie to your home and lifestyle:

How did you hear about Rocky Mountain Collie and Sheltie Rescue?