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NVSR Online Application Form
Thank you for applying to adopt a Sheltie from Northern Virginia Sheltie Rescue (NVSR). Please read ALL of the "How to Adopt" section of this website before you fill out the application. This form, upon completion, will be emailed to our Adoptions Team.
Section I: About You
(Applicant must be at least 18 years old)
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Indicates required field
Name
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First
Last
Address
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Line 1
Line 2
City
State
Zip Code
Country
Home Phone Number
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Work Phone Number
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Cell Phone Number
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Birth Year
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Email
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Employment
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Full time
Part time
Retired
Not currently employed
If employed, please list your employer, position, and how long you've worked there:
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Co-Applicant Name
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First
Last
Relationship to Applicant
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Spouse / Domestic Partner
Parent
Child
Roommate
Other
If Other please specify:
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Co-Applicant Birth Year
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Co-Applicant Employment
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Full Time
Part Time
Retired
Not currently employed
If the co-applicant is employed, please list their employer, position, and how long they've worked there:
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Are you or your co-applicant in the military?
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Yes
No
Have you placed an application with any other rescue groups?
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Yes
No
If yes, which ones?
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Please note:
Applying with other rescue groups does not affect whether or not we will work with you. We cooperate with other rescue groups in order to find each dog the best possible home.
References:
Please list names of two people who know you well and perhaps have known your animals. You may list a relative if you like. Note: By completing this section, you give us permission to contact these people on your behalf.
First Reference Name
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First
Last
First Reference Phone Number
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First Reference Address
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Line 1
Line 2
City
State
Zip Code
Country
Second Reference Name
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First
Last
Second Reference Phone Number
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Second Reference Address
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Line 1
Line 2
City
State
Zip Code
Country
Veterinarian
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Veterinarian Phone Number
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Section II: About Your Home
What are your living arrangements?
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Own
Rent
Live with parents
Please check all that apply:
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Home
Apartment
Townhouse
Duplex
Mobile Home
Other
If other, please explain:
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How long have you lived at this residence?
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What is the speed limit of the road you live on?
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If renting, please provide your landlord's contact information below. Note: by providing this information, you give NVSR permission to contact your landlord.
Landlord Name
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First
Last
Landlord Phone Number
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Landlord Address
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Line 1
Line 2
City
State
Zip Code
Country
Are you planning to move within the next year?
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Yes
No
If yes, where and why:
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Are there restrictions that prevent you from having a dog or have a size limit on a dog?
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Yes
No
If yes, explain:
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Do you have permission from the property owner to have a dog?
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Yes
No
N/A - I own my home
Please note: Proof of ownership or lease with pet clause may be requested to be viewed.
Please tell us the ages and relationship of all the people who live in your home:
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Do you have any children visit on a regular basis (for example, grandchildren)?
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Yes
No
If yes, what are their ages?
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Do you have a yard, securely and physically fenced so that a small animal could not escape?
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Yes
No
If yes, describe the fence material and height:
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If yes, how large is your fenced yard?
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Does a door from your home open directly into the fenced yard?
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Yes
No
N/A - I don't have a fenced yard
If you don't have a fence, do you plan to install one?
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Yes
No
N/A - I have a fenced yard
If yes, when and what kind?
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Section III: About Shelties and You
What are your expectations about a Sheltie as a pet; what do you know about Shelties?
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Have you ever owned a Sheltie?
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Yes
No
If yes, please tell us about your experience:
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Where will an adopted Sheltie be kept while it is alone during the day?
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Where will an adopted Sheltie be kept at night?
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Is anyone home during the day?
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Yes
No
If yes, who?
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If yes, for how many hours/day are they home?
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How many hours will this dog be alone each day?
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Who will be responsible for the care of this dog (feeding, exercising)?
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How frequently do you travel?
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Who will care for this dog while you are away on overnight absences?
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How much do you think it will cost to care for a Sheltie each year? (Consider the cost of veterinary care, food, licensing, boarding, etc.)
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How will this dog be allowed to relieve itself daily?
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I will let it out in the fenced yard
I will walk it on leash
I have a doggie door, so it can come and go as it pleases
I have a "tie-out" trolley or stake
I use "puppy pads" so it doesn't have to go out
Other
If you selected other, please explain:
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How will the dog be exercised (check all that will apply)?
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I have a fenced yard where it can run and play
I/We will play with the dog in the yard
I will walk it on a leash
I will run/jog with the dog
I will take the do to a securely fenced dog park
Other
If you plan to leash walk your dog, please indicate how many miles per day:
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If you selected other, please explain:
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Section IV: About Your Other Pets
Please list all your current pets, including: Breed, Name, Sex, Age, Spay/Neuter Status
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Are all pets current on vaccinations?
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Yes
No
If no, please explain:
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Please list additional pets you have owned in the last ten years, including Breed, Name, Sex, Spay/Neuter Status, and where it is now (did it die or was it rehomed)?
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If you have ever had a pet die at an early age or in an accident, please explain:
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What brands of heartworm preventative and flea/tick control do you use for your dogs?
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Have you ever participated in obedience training with a dog?
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Yes
No
If yes, please answer the following questions:
When?
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Who was your trainer?
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What methods of training were you taught?
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Did you continue your dog's training after the class?
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What were the results?
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Would you be willing to take the adopted Sheltie to obedience training?
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Yes
No
Maybe
Are you willing to work with a Sheltie who may need remedial housetraining?
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Yes
No
Maybe
If "No" or "Maybe" on either of the prior two questions, please explain:
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Section V: About Your Desired Sheltie
What is your gender preference?
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Would you consider the opposite gender?
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What is your color preference?
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What size Sheltie would you prefer?
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What age range would you prefer?
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Would you consider a Sheltie mix?
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Would you consider an older Sheltie? If yes, up to what age?
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Would you consider a bonded pair?
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Would you be willing to adopt a "special needs" (blind, deaf, sick, 3-legged, needs medication, overly shy) Sheltie?
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If yes, what kind of special needs would you consider?
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Would you be willing to work with a behavior problem Sheltie?
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If yes, what kinds of problems are you willing to work with?
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Please tell us about the temperament of the Sheltie you'd like to adopt. For example - playful, energetic, active, quiet, low energy. Please elaborate - this is very helpful to us.
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Is there a Sheltie quality that you do NOT want?
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If you are interested in a specific Sheltie, please add their name here:
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Please add any information that we haven't covered so far that will help us know you better:
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Section VI: Affirmation
I accept that, to help defray NVSR's expenses for rehabilitating and helping the next rescue Sheltie, there will be an adoption fee (puppy to 3 years old - $450; adult 4 to 9 years old - $350; senior 10 years and older - $200). These fees may change and depend on the dog under consideration.
I affirm that no legal charge for animal abuse has ever been made against me or any immediate family member.
I have read and understand the complete page "How to Adopt" on the NVSR website.
I acknowledge that all the information contained on this form is true and correct. I understand that any misrepresentation of fact may result in the reclaiming of the adopted dog by NVSR.
Typing your name(s) here constitutes a formal signature:
Applicant Name
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Co-Applicant Name
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NVSR reserves the right to refuse any applicant.
Thank you for taking the time to fill out this application; it is essential to the adoption process. NVSR is a non-profit organization that desires only to place these wonderful Shelties in loving homes and give them a second chance at a happy, healthy life. If you are patient with our process, we will try to provide you with a devoted and loving companion.
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