1. Care of Our Rescues: As rescue Shelties, our dogs have already been through enough heartache in their lives. Dogs adopted from Northern Virginia Sheltie Rescue will not be used for animal research or experiments, breeding, attack training, or dog fighting; they will not be tied up or chained, confined exclusively outdoors, abused, neglected, given to another owner, or abandoned to the streets. Northern Virginia Sheltie Rescue reserves the right to check on the status of our rescue Sheltie and to request updates, removing our rescue Sheltie if we discover these terms are violated by the adopter. 2. Return: The adopted dog may be returned to Northern Virginia Sheltie Rescue within two weeks of the date of adoption for full refund of payment if the adopter is not satisfied with any aspect of the adoption. After two weeks from the above date, no refund will be given even if the dog is returned to Northern Virginia Sheltie Rescue. 3. Transfer of Ownership: The adopted dog may not be transferred to any other person for any reason. If the adopter is forced to relinquish custody of the dog at any time, said dog will be relinquished only to Northern Virginia Sheltie Rescue. 4. Refund: There will be no refund or reimbursement for any expenses incurred by the adopter for the adopted dog, even if it is returned to Northern Virginia Sheltie Rescue. 5. Health Program: The adopted dog will be cared for humanely, including adequate food, shelter, water, year round heartworm preventative, and routine and emergency veterinary care Booster vaccinations shall be administered at least once a year with a routine examination. The dog will be licensed in accordance with the laws in the jurisdiction in which he resides. The dog is to be exercised in a fenced yard or on a leash and NOT TO BE FREE TO ROAM THE STREETS.. 6. Loss: If the adopted dog is lost or stolen, the adopter will notify Northern Virginia Sheltie Rescue immediately so we can use our resources to help locate the dog as soon as possible. 7. Reservation of Rights: Northern Virginia Sheltie Rescue reserves the right to examine and make inquiry about said dog at any time. If the terms and conditions of the Adoption Agreement are not upheld, Northern Virginia Sheltie Rescue reserves the right to terminate the Agreement and to reclaim the dog. 8. Northern Virginia Sheltie Rescue makes no representations or warranties concerning the health, temperament and/or previous ownership of the dog. Adopter understands that Northern Virginia Sheltie Rescue shall not be liable for any medical care or treatment of the dog. Adopter agrees to indemnify and hold harmless Northern Virginia Sheltie Rescue and/or their representatives, for and against any and all manner of actions and causes of actions, suits, debts, dues, accounts, bonds, covenants, agreements, judgements, claims, and demands whatsoever arising out of or relating to the adoption, placement, and/or possession of the dog.
9. Return Check Charge: There will be a $35.00 charge on all returned checks submitted by the adopter.
10. Why so many questions? Please read How Could You?
*Indicates Required Fields
*Name *Date (Must be at least 18 years of age)
*Street Address Apt No.
*City *State AK AL AR AZ CA CO CT DC DE FL HI IA ID IL KS KY LA MA MD ME MN MO MS MT NC ND NE NH NJ NY OK PA RI SC SD TN TX VA VT WA WV WY *Zip
*Home Phone Fax *E-mail
Birth Date
Employer Position
Employer's Phone
If less than one year, where previously employed?
Previous Employer's Phone
Co-Applicant Information (if applicable)
Name Relationship to applicant Spouse Parent Child Roommate Other
Have you or any member of your family ever been convicted of cruelty to animals or any related charge? No Yes
If answer is yes to above, explain:
Is any such charge currently pending? No Yes
Identify person in local area (non-relative) who knows you well and perhaps has known your animals:
*Name
*Address *Phone
*Name of relative in local area (not living with you)
May we check your references and verify the information you provided? Yes No
*Please explain why you want a Sheltie
*What are your expectations about a Sheltie as a pet?
*What do you know about the breed? (temperament, health)
Have you ever owned a Sheltie before? Yes No Do you realize Shelties are barkers? Yes No Do you realize Shelties may be somewhat shy around new people and may take a while to bond? Yes No
What are your living arrangements? Rent Own
*Please check those that apply: live with parents house townhouse condo apartmentduplex mobile home other
If other please explain:
How many stairs will Sheltie need to negotiate to get outside and within home?
If renting, please provide your landlords name, address and phone number:
*How long have you lived at your current residence?
Are you planning to move in the near future? No Yes If yes, explain:
Are there any covenants (restrictions) that prevent you from having a pet? No Yes
If yes, please explain:
Do you have permission from this property owner to have a dog? Yes No Not Applicable (Proof of ownership, or lease with pet clause may be requested.)
*Where will this pet be kept while you are away or at work?
*at night?
Is anyone home during the day? Yes No If yes, who?
How long is this person home during the day?
Do you work full time or part time? Full time Part time
*How many hours will this pet be alone per day?
*How many adults live in your home? *How many children?
If there are children, what are their ages?
Is anyone in your house allergic to animals? No Yes
If yes, please explain how the allergy will be treated if you are bringing in a dog:
*How frequently do you travel?
*Who will care for this animal while you are on vacation?
Are you or your spouse in the military? No Yes
If you have to move, what will you do with this animal?
Are you willing to take responsibility for this animal for the next 10 or more years? Yes No
*Why do you want to adopt a sheltie? Companion Watch Dog Gift To Breed
Personal Protection For Children Other
If other, please Explain:
*What will you do if the dog gets sick?
Will this pet be taken annually to the veterinarian for rabies, distemper, hepatitis, leptospirosis, parainfluenza, and parvovirus inoculations, and be checked for parasites and heartworm? Yes No
*How will you control fleas/ticks?
Will this pet be kept on heartworm control year around? Yes No
Do you currently have any other animals? No Yes If yes, please list (breed, name, sex, spayed/neutered)
Please list all pets you have owned in the last ten years (breed, name, sex, spayed/neutered)
Where is/are it/they now?
Are all animals current on all vacinations? Yes No Not applicable
If you have ever had a pet die at an early age or in an accident, please explain:
Do you have a (totally closed, secured) yard? Yes No
If yes, please describe (type of materials, height, amount of space, condition):
If you don't have a fence, do you plan on building one in the near future? Yes No Not Applicable
*How do you plan to exercise the dog?
Do you plan to tie or chain the dog outside at any time? No Yes
If so, please explain:
Have you ever participated in obedience training with a dog? Yes No
If so, when? Who was the trainer? (name & phone)
What methods of training were you taught?
If required, are you willing to take the dog to obedience training? Yes No Undecided
If no or undecided, please explain:
Do you have a veterinarian? Yes No If yes, may we contact them? Yes No
Veterinarian's Name & Phone:
Please tell us how you found out about our rescue:
Do you have a gender preference? No Yes If yes, which gender Male Female
Would you consider the opposite sex? Yes No
Do you have a color preference? No Yes
Color Preference No Preference Sable & White Tri-color Blue Merle Second Choice No Preference Sable & White Tri-Color Blue Merle
What size Sheltie do you prefer?
What age range would you prefer?
Would you consider an older, more needy dog? Yes No Maybe
Would you consider a sheltie mix? Yes No Maybe
Would be willing to take a special needs (blind, deaf, sick) dog? Yes No Maybe
Would you be willing to work with a behavior problem dog? Yes No Maybe
Would you consider littermates or a bonded pair? Yes No Maybe
Do you have any special needs or desires?
Applicant I accept all NVSR terms and conditions by submitting this application I do no accept all NVSR terms and conditions by submitting this application
Co-Applicant No Co-Applicant I accept all NVSR terms and conditions by submitting this application I do not accept all NVSR terms and conditions by submitting this application