Date of Application:
Full Name (required):
Address (required)
City (required)
State (required)
Zip (required)
Home Phone (required)
Work Phone
Cell
May we call you at work? Yes No
Your Email (required)
1. Are you interested in adopting a dog we have on the website? Yes No
- Which dog(s) are you interested in?
2. The reason I am interested in adopting a Collie or Sheltie is:
3. Have you ever owned a dog before? Yes No
4. Have you ever owned a Collie or Sheltie before? Yes No
5. Do you have any pets now? Yes No
- If so, what are they? How old? Are they spayed or neutered?
6. Have you ever been involved in obedience, agility, herding, or other organized dog activities? Do you plan to be?
7. Have you ever adopted a pet from a shelter/rescue group before? Yes No
- Was it a positive experience? Yes No
8. Family Information: Adults (number & ages)
- Children (number & ages)
9. Is everyone in your family enthusiastic about adopting a rescued Collie or Sheltie? Yes No
10. Is anyone in your home allergic to animals? Yes No
- If Yes (please explain)
12. Do you own your home? Yes No
- If you rent does your landlord approve of your adopting a Sheltie or Collie? Yes No
- Please provide name/address/phone# of your landlord:
- Name:
- Address:
- Phone #
13. Is your property fenced? Yes No
- If Yes, please describe your fence (block, chain link, wood)
14. How high is your fence?
15. Can children open your gates? Yes No
16. Can a dog dig under or jump over your fence? Yes No
17. Do you have to use steps or stairs to enter or exit your home? Yes No
- Do you have stairs inside your home? Yes No
- If yes, please explain
18. Will your dog live inside? Outside? Or both?
19. Do you have a doghouse or kennel? Yes No
20. Will you use a chain, tie-out or cable runner to restrain your dog outside? Yes No
21. Do you have a doggie door? Yes No
22. Where will your dog sleep at night?
23. How will you exercise your dog?
24. During the day, where will your dog typically stay?
25. How many hours a day will your dog be alone, and where will your dog stay during that time?
26. What brand of dog food do you use?
- Are you satisfied with the quality? Yes No
27. Would you welcome advice about other foods for your Collie or Sheltie? Yes No
28. Who will care for your dog when you travel out of town?
29. Has any member of your household ever been charged with cruelty to animals? Yes No
30. How would you react if your dog destroyed a household object or soiled in the house?
31. 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? Yes No
- Are you willing and able to provide that care? Yes No
32. Do you currently use a veterinarian for your pet health care needs? Yes No
33. How long have you been going to this clinic?
34. Please provide your veterinarian's name and contact information:
- Name
- Address
- Phone
I prefer the following breed Collie Collie Mix Sheltie Sheltie Mix No Preference
I would prefer the following gender
I prefer the following color(s) Sable Tri-Color Blue Merle No Preference
35. What age dog would work best for you?
36. How much energy should your dog have?
37. I expect to do grooming
38. Collies and Shelties are sometimes "barkers." Will that be a problem? Yes No
39. Would you consider a dog with special needs, such as deafness, blindness, behavior problems, health problems, or old age? Yes No
40. Please tell us a little about yourself so that we can match the right Collie or Sheltie to your home and lifestyle:
41. How did you hear about Rocky Mountain Collie and Sheltie Rescue?
Please allow 48 hours for us to process your application. We will get back to you with a confirmation that we received your application at that time. If we feel that your application will meet our guidelines we will be back in touch with you by phone for an interview.
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