This is not a web form!

You can view, print or copy and paste it into a Word document or email message.  If copied into a Word program, please submit the application by attaching the document to an email.  Please don’t copy and paste the Word document into an email, it doesn’t copy properly.  If printed and filled out by hand, please submit by regular mail to the address below.  A scanned copy usually doesn’t send or arrive properly.  Please don't send Applications in Excel format.  If you have any questions or problems please contact our Webmaster at webmaster@sheltierescueetn.com

Sheltie Rescue of East Tennessee

Adoption Application

Name: ______________________________________________

Address: ______________________________________________

City:__________________ State:_______ Zip___________Phone:________________

E-mail address: ______________________
Occupation:  _____________________________________________

1.  Why do you want a Shetland Sheepdog? ______________________________________________

______________________________________________

______________________________________________

______________________________________________

2.  Have you ever owned a Sheltie before? _____________

     Do you still have that dog?  _______________________

3.  What happened to your last dog? __________________

4.  During the past two years:

         a.  Have you lost a pet (not through death)? _________

         b.  Have you had one poisoned?   ________________

         c.  Have you had one killed by a vehicle?  __________

         d.  Have you had one die due to disease?  _________

5.  For what purpose do you want this dog? _______________________________________________

_______________________________________________

_______________________________________________

6.  Do you have any other animals? _______

     If yes, list type, age & sex _________________________

_______________________________________________

_______________________________________________

7.  Do you have children at home ___ Number:____

     Age(s): __________________

8.  Do you live in a house?_______ Apartment ___________

     Condo?_______Trailer?_____

9.  Do you rent or own? _____________________________

10. If you rent, do you have the landlord’s permission to keep a dog?____

11. Do you have a yard?_______ Is it fenced?_______

      What type of fencing? ___________________________

12. Do all adults in the family work?____

       Is someone home during the day? ____

       Please explain: _______________________________

13. What provisions will be made for your Sheltie if no one is home during the

       day?________________________________________

                ________________________________________

                ________________________________________

14. Do you intend to keep this dog primarily indoors or outdoors?  _______

      Where will it sleep? ____________________________

15. Do you have a sex preference?  Male___ Female___

       No preference_______

16. Do you have a color preference?  Color _____ Second choice _____

      No preference  _______

17. Would you consider an older dog? _____To what age? ______

18. What size Sheltie do you prefer?   __________________

19. Are other members of your household aware that you are considering

      adopting a dog? ____ Do any of them have any objections?____

20. Are you prepared to accept the financial responsibilities of caring for an

      animal, including veterinary care, good quality food, licensing, etc?___

21. Are you planning to move in the near future?  __________

22. Is anyone in your house allergic to dogs? ____________

23. Are you familiar with the animal control regulations in your area?   ___

24. Is this dog going to be a gift? ___ For whom? _________

      Do they know they are getting the dog? ______________

25. Do you understand that any rescue Sheltie you may adopt through Sheltie

      Rescue will be spayed/neutered? ______

26. What circumstances, in your mind, justify getting rid of a dog? ________________________________________________

________________________________________________

________________________________________________

27. Are you willing to allow a rescue representative to visit your home by

      appointment?__________________________

28. Do you accept that there will be a fee ranging from $250 for puppies to

      $100 for senior and special needs dogs to adopt a dog? _____________

I am in full agreement with the Sheltie Rescue of East Tennessee Terms of Adoption (attached). 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 adoption of a rescue Sheltie.

Date_______________       Signature______________________________________

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 of East Tennessee. If you have any questions, or if we can be of any assistance, please do not hesitate to call.

                                  We reserve the right to refuse any applicant.

If mailing please return to:   Sheltie Rescue of East Tennessee

                                               c/o Brenda Jenkins

                                               810 Fish Hook Rd.

                                               Mosheim, TN  37818  (423) 787-7712

If e-mailing please send to the person fostering the Sheltie you are interested in.
___________________________________________________

Sheltie Rescue of East TN Official Use Only

Approved_______Disapproved_______

Staff Member:___________________________________

Date:_____________

Comments:__________________________________________

___________________________________________________

___________________________________________________

Dog Adopted_______________Number_______________

Date:________