Please email completedapplications to (incomplete applications will cause processing delays)

Date:

  • Applicants Information

Name:

Address:

City, State, Zip:

Main Phone #:

Alt Phone #:

DOB:

DL#:

Email address:

Employer:

Work #:

Occupation:

  • Co-Applicant Information

Name:

Main Phone #:

DOB:

DL#:

Email address:

Employer:

Work #:

Occupation:

  • Name of dog you are interested in:

Why did you choose this dog?

What is the best time to call?

How did you hear about us?

  • Home Information

Residence type (House/Apartment/Other/etc):

Do you own, rent, etc:

Landlord’s name and number:

Do you plan to move in the next year?

If yes where & new address?

Number of adults in the household:

Number of children and ages:

Will there be any restrictions between the new pet and children (please explain)?

Do you have a fenced yard?

Type of fence and height:

Are there locks on the gates?

Are there areas that would allow for escaping?

Do you have adequate shade and shelter?

If you do not have a fence how do you plan to exercise your pet?

Is there anyone in household allergic to animals?

Have you had pets before?

Who will be the main caregiver?

On average how many hours will your pet be left alone?

Do you travel frequently?

Who will care for your pet when you are away?

Where will your pet be during the day?

Where will you pet stay at night?

What type/brand of dogfood do you plan to feed?

The type of nutrition you provide for your dog is very important as this can directly affect a dogs health thus its life span. Are you willing to provide this dog with a dog food listed on as a 4 or 5 STAR dog food if the dog food you listed above is not rated as such?

  • Veterinarian/Medical Information

Veterinarian clinic of choice:

Veterinarian Name:

Address:

Phone #:

Are you planning to keep this dog current on routine vaccinations and familiar with its costs?

Are you planning to keep this dog on monthly flea prevention and familiar with its costs?

Are you planning to keep this dog on monthly Heartworm Prevention familiar with its costs?

Are you aware that dogs need dental care and are you willing to provide routine dental care for this dog?

May we contact your veterinarian for reference?

Have you had pets with past or present pets with medical issues?

  • Training Information

Are you familiar with crate training?

Have you ever house trained a dog before?

What behavioral issues will you not tolerate?

If adopting a puppy are you ready for the chewing stage?

If needed are you willing to continue house training/potty training?

Are you willing to work with possible jumping/nipping/digging?

What activity level are you looking for?

How long are you willing to let your new dog adjust?

What traits are you looking for?

Do you plan to attend obedience or training classes?

What activities if any do you plan to do with this dog?

  • General Information

Have you ever given away or surrendered a pet to a shelter?

If so why?

Have you ever adopted from a shelter or a rescue before?

If so where and when:

Under what circumstance would you return this dog?

Do you agree to return this dog to us if adoption fails?

What is your desiredweight/height for a dog?

Would you allow a home visit as part of the adoption process?

Would you allow a follow in home visit after adoption?

Are you willing to travel to meet your potential new dog?

Have you ever owned an Aussie of any size?

If not what do you know about this breed:

Why do have you chosen to adopt a Mini Aussie/Toy Aussie?

What are your plans for the Mini Aussie/ Toy Aussie you are interested in adopting: Pet, Guard, Herding, Obedience or other (please explain)?

Australian shepherds of all sizes are herding dogs that often desire a job or participating in some type of activity. What type of job/activities if any are you planning to do with this dog (agility, herding, Disc, Fly ball, Walking, etc)?

Anything else you would like to tell us about (use as much room as needed)?

  • Are you aware of the MDR1 gene and the types of medications that are considered to be harmful or deadly to Australian Shepherds of all sizes?
  • Personal References (provide 2)

Name:

Address:

Phone:

Relationship to applicant:

Name:

Address:

Phone:

Relationship to applicant:

  • Current or Previous Pets

Please provide the following for all current or previous pets in the space below. Use as much space as needed. Please copy and paste the below pet information if you have/had more than 4 pets.

Pet #1:

  • Name:
  • age:
  • breed:
  • gender:
  • spayed/neuter/intact:
  • current vaccination status:
  • If no longer in your care please explain why:
  • If deceased please indicate the cause:
  • Veterinarian Name, Address & Phone if different than above:

Pet #2:

  • Name:
  • age:
  • breed:
  • gender:
  • spayed/neuter/intact:
  • current vaccination status:
  • If no longer in your care please explain why:
  • If deceased please indicate the cause:
  • Veterinarian Name, Address & Phone if different than above:

Pet #3:

  • Name:
  • age:
  • breed:
  • gender:
  • spayed/neuter/intact:
  • current vaccination status:
  • If no longer in your care please explain why:
  • If deceased please indicate the cause:
  • Veterinarian Name, Address & Phone if different than above:

Pet #4:

  • Name:
  • age:
  • breed:
  • gender:
  • spayed/neuter/intact:
  • current vaccination status:
  • If no longer in your care please explain why:
  • If deceased please indicate the cause:
  • Veterinarian Name, Address & Phone if different than above: