Patchwork Sheltie Rescue of Southeastern Pennsylvania
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Patchwork Sheltie Rescue of Southeastern Pennsylvania
Adoption Application


Personal Information:

First Name: MI: Last Name:
Address 1:   Address 2:
 
City: State: Zip:
Home Phone:   Work Phone:
( )   ( )
Email Address:   Do you check email every day?
 
Employer:   Hours you are at work:
 
May we call you at work?    
   

Pet Information:

Name of the dog you are applying for:

First Choice: Second Choice: Third Choice:

Do you have an application pending with any other rescue group?

Why do you want a Sheltie?

Please tell us about ALL of the pets you've had in your adult life:
Breed: Sex: Neutered or Spayed:
What happend to this animal?
Please be Specific:
Breed: Sex: Neutered or Spayed:
What happend to this animal?
Please be Specific:
Breed: Sex: Neutered or Spayed:
What happend to this animal?
Please be Specific:
Breed: Sex: Neutered or Spayed:
What happend to this animal?
Please be Specific:
Breed: Sex: Neutered or Spayed:
What happend to this animal?
Please be Specific:

If your current or previous pets were not spayed or neutered, please explain why?

Do you keep all of your pets up to date on all shots?
Heartworm prevention medication? Flea prevention medication?   
Do your pets have yearly vet check-ups? Licensed in your county?    
Which brand of Heartworm prevention and or Flea prevention medication do you (did you) use on your pets?
 
Who is your current/previous Veterinarian?
Vet's Address:
City and State: ,
Telephone Number: ( )  
May we use your vet as a reference?  

Do you intend to keep this dog indoors or outdoors?
Where will the dog sleep?

Do you have the time and or patience to housetrain a dog, if it is not already trained?
Would you be willing to take a "special needs" (blind, deaf, handicapped) dog?
Would you be willing to work with a "behavior problem" dog?
Would you be willing to take a much older, more needy dog?
Have you ever owned a Sheltie before?
Are you aware of all a Shelties needs? (i.e. grooming, exercise)
Are you aware that Shelties are "barkers"?
Are you aware that Shelties may be somewhat shy around new people, and may take awhile to bond with?

Do you have a color preference?
Do you have a gender preference ?
Do you have an age preference?
Do you have a size preference?
Are you aware of the financial responsibilities of dog ownership…. Including vet care, medications, food, licensing, shots, grooming…etc?  And that total expenses of owning this dog could be $1000.00 per year?
Would this dog be a priority in your life?

Check any of the following circumstances that would force you to give up this dog (Check all that apply)
A new job or working long hours Illness Divorce
Bad habits (pottying in the house, destruction, ... etc etc.) Moving to house or apartment that won't allow pets If it bit someone
New baby Other (please explain)

Home Information:

Please list the names, relationship and ages of everyone living in your house. Please include anyone who lives with you part-time.
Do you link in a:  
House Apartment
Condo Other (Please Specify)
If renting, does the landlord allow pets?
Do you have a fully fenced yard (with no gaps) for the dog to use?
Does the door that you will use to let the dog outside, open directly in to the fenced area
If not, how will the dog be exercised?
Will this dog be home alone during any part of the day?
If so, during what hours?
Where will this dog stay while you are gone?
Please check all that apply in yoru home:
Moderate - normal comings and goings Busy household - visits by friends, in and out a lot, children, parties at home
Live on busy street Quiet - "homebodies" few guests, come home and stay home
Lots of children in the neighborhood Noisy - TV, stereo, machinery, tools, children playing, dogs barking

Fees:

Are you aware of the fees that our rescue organization charges?
Puppies up to 1 year old minimum donation $ 250
Adults 1-10 minimum donation $ 175
Senior Adults 11+ minimum donation $ 100

Please check to be sure all questions are answered.  Incomplete applications are not accepted.

OR click here to download a pdf version of this application to submit via snail mail.

Please note that we have the right to refuse any applicant

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