First Name*
Last Name*
Address*
City*
State/Province*
Zip/Postal Code* -
Email*
Home Phone
Work Phone x
Cell Phone*
Which Sheltie are you interested in adopting? Choose an animal: Baxter Blue Emmy Toby 2024
What is your date of birth?*
Occupation*
Spouse's Name
Spouse's DOB
Spouse's Occupation
Describe why you would like to adopt a dog and why have you chosen a sheltie?*
Have you ever owned a Sheltie before?*
Please list Past and Present Pets and what happened to them*
Are/Were your pets spayed or neutered?*
Are/Were your previous pets current on their vaccinations?*
Are/Were your previous pets on Flea and Heartworm prevention?*
What Brand of Heartworm and Flea Prevention do you use?*
For what purpose do you want this dog?*
Are there children living in your home?*
If there are children in your home, how many and what are their ages?
What type of home do you live in?* Choose one: Single Family Duplex Apartment Townhouse Condominium Mobile Home Military Housing
Do you own or rent your home?*
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
We require our shelties to have a fenced yard, is your yard fenced?
What type of fence* Choose one: Privacy Chain Link Invisible
What is the height of the fence*
Is someone home during the day?*
Number of hours a day no one will be home?*
Where will your sheltie be kept when you are not home?*
How will you exercise your dog?*
Where will your Sheltie sleep at night?*
Are other members of your household aware that you are considering adopting a dog?
Is anyone in your household allergic to dogs?*
Are you prepared to accept the financial responsibility of caring for an animal, including veterinary care, good quality food, grooming, licensing etc?* Choose one: Yes No
What will you do with the dog if you move?*
Are you familiar with the local animal control regulations?*
What circumstances, in your mind, justify getting rid of a dog?*
Have you applied with any other rescue Choose all that apply: Yes No
Are you willing to have a rescue volunteer visit your home by appointment?*
Please list the names and phone numbers of all veterinarians used in the last 7 years.*
May we call your vet?*
Do you, or others in your household have any concerns about adopting a Sheltie? If so, what are your concerns?*
I understand that by submitting this form, I am attesting to the truthfulness of my answers. I understand that false information on this form will be grounds to disallow adoption of a rescue Sheltie.* Choose one: Yes No
BELOW FOR OFFICIAL USE ONLY
Vet Reference checked by
House/Fence check by
Date
Petco
6801 W 75th Street
Overland Park, KS 66204
2nd and 4th Saturday each month
11:00 am-1:00 pm