Contact Information
First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
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County*

Email*

Home Phone*

Cell Phone*

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About You
Please Read and Acknowledge: We get many applications for each dog, and of course, we can only choose one of them. We look over all applications for each dog, and we choose the BEST FIT FOR THE DOG. We do not go by first come first serve. Therefore.... if you are not chosen for a particular dog, it does not mean you were denied or turned down. It simply means that for this particular dog, we found a better match. Please check the little button below to indicate that you understand how our selection process works.*

I agree
Which dog are you most interested in?*

Choose an animal:

Please choose a dog as your 2nd choice.

Choose an animal:

Did you read the FULL bio on this dog, and feel you meet all the criteria?

Would you consider adopting 2 dogs if they were bonded?*

If you are approved to adopt one of our dogs, will you agree to come to adopt within 10 days of being approved?

Please list ANY physical limitations that may affect how you lift, walk with, interact with, or care for a dog? *

Are you able to pick up and carry a dog from inside your home - to your car, and then drive the dog to your Vets office.......and then carry him inside the Vet clinic?*

Are you a monthly supporter of CISR? Explain if needed*

What is your date of birth? (mm/dd/yyyy)

If there is a co-applicant, please provide their name and date of birth.

Please list any additional email addresses where we can reach you.

Address of your second, or vacation home

Amount of time spent at second home?

Do you work from home? Or go into an Office? Explain.*

Name of your employer

Position held

Spouse or partner or co-applicant's employer

Position held

Does ANYONE in the house smoke inside? Or JUST outside?*

Have you owned a Sheltie before?

Choose one:

Are you aware of how skittish Shelties are with new people, places, and things?

Choose one:

Are you aware that Shelties are not good with small children?

Choose one:

Why do you want to rescue a Sheltie?

Please take some time and describe for us what personality you are looking for in a Rescue Sheltie. The younger the dog, the more training time you will need to provide. Do you want a jogging partner? A TV watching partner? A hiking partner? A dog that will be happy being home alone all day while you are at work? A dog to play with your children/grandchildren? Please take some time on this question.*

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Working with a Rescue or Shelter
Have you adopted a dog from us in the past?

Choose one:

If you have adopted from us in the past, who did you adopt and when? Please list all.

Have you adopted from another rescue group in the past? If yes, tell us about that.

Do you have an application pending with another Rescue or Shelter? If yes, please list name of Rescue. If no, please type N/A

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Your Home
Please list the names, relationships, and ages of everyone living in your home, even part-time.

What type of dog are you looking for?

Indoor companion Indoor / Outdoor dog
Outside dog (with kennel and fence) Outside dog (no fence)
Outdoor Working dog (sheep, cattle) Agility Dog (have experience in agility)
Other performance dog Guard/Alert dog
Please check ALL that apply to your home.

Busy household-friends, children, parties In-ground pool in yard
Lots of children in the neighborhood Lots of wildlife - deer, fox, coyote, etc.
Noisy - TV, stereo, music, machinery, tools, etc. On a busy street or highway
Stray dogs or neighbors let their dogs run loose Very quiet, no children, few guests
Please select the type of home you live in

Choose one:

Please check all that apply to the area you live in.

Assisted Living Community Downtown or other busy areas
Gated community In town, residential street, normal-sized lot
Mobile home park Rural home, acreage, woods, or fields
Secluded - surrounded by heavy woods Subdivision with one or more acres of land
Well-developed subdivision, houses all around Working farm - cattle, horses, other livestock
Other
If you chose other, please elaborate.

What is the speed limit of the road on which you live

Do you own or rent your home?

Choose one:

Are you planning to move in the foreseeable future?

Choose one:

If you do move away from this home, what would you do with this new dog?

Choose one:

If you selected "Other," please elaborate.

How often to you have children under age 10 in your home?*

How will you handle your Sheltie when you have a young child visiting your home?

If you selected "Other," please elaborate.

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Play/ Potty/ Exercise Space
Is your yard securely fenced on all sides, with a physical fence that has no holes or gaps so that a small animal could not escape?

Choose one:

Does an exit from your home lead DIRECTLY to the fenced yard?

Choose one:

Your fenced yard covers (please select one)

Entire back yard Portion of back yard
Dog pen Side yard
Other (please explain in next field)
If your fence does not surround your entire back yard, please explain the space your fence covers

Your fence is (check all that apply)

3-foot tall 4-foot tall
5-foot tall 6-foot tall
Chain link Wood or Vinyl Privacy
Picket Fence Farm or garden fencing
Homemade Other (please explain in next question)
How tall is your fence at the SHORTEST point?*

If you have additional comments about your fencing, use this area to explain

Do all gates have locks on them to prevent unauthorized entry? Please answer yes or no, or explain if needed.

If you have a picket fence, how many inches gap is there between pickets?

Do you plan on your new dog using this fenced yard as its primary play/potty space? Please explain.

When was the last time you inspected your entire fence for holes or gaps?

Can your current (or prior dogs) be trusted not to run away if allowed to be OFF LEASH? Please explain*

Have your current or prior dogs been trusted to stay near you OFF-LEASH, when outside of your fence.....such as the front yard, or driveway? Please explain*

If you would ever allow this dog to be off it's leash in an unfenced area, please explain under what conditions?

If you were to move from your current home, will you ensure your new home has a securely fenced yard prior to your moving in?

If you do not have a fenced yard, how will this dog be exercised, go for potty breaks, etc.

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Daily Schedule
Do all the adults in your household work outside the home?

How many hours a day will this new dog be home alone?

Where will this dog stay while home alone?

How much time per day are you able to devote to training and interacting with this new dog?

Do you allow dogs to sleep on your bed with you?

Choose one:

Are dogs allowed on your furniture?

Yes No
Some furniture Other
If you selected "Other," please elaborate.

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Your Pets
Please tell us about your past and present pets.

Please list all of your current Pets.
Please use this format:
Name | Breed | Weight | Fixed? | Sex | Micro-chipped? | Age now | Date Acquired

Please list of all your PRIOR Pets.
Please use this format:

Name / Breed /Dates Owned / Cause of death or Rehoming

If any of your present or past pets were not spayed or neutered, please tell us why.

Have you ever bred any of your dogs? If yes, please elaborate.

Have you ever had to give up a pet? If yes, please elaborate.

Have you ever had a pet stolen or lost? If yes, please elaborate.

Have you ever had a pet hit by a car? (If yes, please elaborate.)

Have all your current and past pets been microchipped? (If no, please elaborate.)

What vaccinations do you give your pets and how often?

What is heartworm and how do you prevent it?

How do you protect your pets from fleas and ticks?

How often do you check for tick-borne diseases?

How often do your pets receive a full physical exam from your veterinarian?

What blood tests do you have run at those exams?

Are you aware that Shelties have very high-maintenance teeth?

Choose one:

Are you aware that Shelties need very frequent dental cleanings performed by your vet?

Choose one:

Please explain the Dental Care your current or prior pets received.

If you currently own a Sheltie or other small breed dog, what was the date of it's last dental cleaning?

How often do you have a stool sample checked by your vet for parasites?

What do you plan on feeding your new dog?

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Veterinarian Information
Please list your CURRENT veterinarian information (name, address, phone number).

Dates you have used this veterinarian.

Do you give CISR permission to speak to your veterinarian as to the care you give your pets?

Choose one:

Please list your PAST veterinarian information (names, addresses, phone numbers).

Dates you used this veterinarian.

Do you give CISR permission to speak to your past veterinarian as to the care you give your pets?

Choose one:

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Your Preferences
Please consider each of the following options carefully. This is what we will use in selecting new homes for our dogs.

Do you want to limit your search to a certain color Sheltie?

Sable and white (brown) Tri-color or Bi-black (black)
Blue Merle or Bi-blue (gray) Color is not important to me
Do you want to limit your foster dog to a certain age range?

Puppy - up to 1 year Young adult 1-5 years old
Mature adult 5-11 years old Senior 11 and older
Age is not important to me
Do you want to limit your search to a certain size Sheltie?

Under 15 pounds 16 to 30 pounds
30 to 40 pounds 40 pounds and over
Size is not important to me
Are you willing to adopt a Sheltie mix?

Choose one:

Are you willing to adopt a Sheltie that needs medication daily?

Choose one:

Are you willing to adopt a Sheltie with special needs (blind, deaf, etc.)?

Choose one:

Are you able to house train a Sheltie that may not yet be house trained?

Choose one:

Are you willing to adopt a VERY shy skittish Sheltie, one that will require much work?

Choose one:

Please describe any quality in a Sheltie that you would NOT be able to work with?

Please check ALL traits that are a MUST from day one. Please be honest and realistic.

Will play with my other dog Must walk well on a leash
Must be house-trained Must come when called
Must like cats Must ride well in a car
Must not run away if loose Must be in perfect health
Must not be shy at all Must be a good Agility candidate
Must do well home alone all day Must be very calm and laid back
Other (Please list below)
Please list any other traits your new dog MUST have.

Please read and acknowledge all of the following facts by selecting that you understand and agree.

Dog ownership carries with it financial responsibilities. The American Kennel Club estimates that it costs, on average, $1,000 - $2000 per year to properly care for a healthy dog. (depending on your area) You are aware of this and can afford to do this.

Choose one:

Most Shelties over age 3 need annual dental cleaning's by your Vet. This procedure can cost several hundred dollars – or more if extractions are required – per event. You are aware of this, agree to do this, and can afford to do this.

Choose one:

At some point in your dog’s life, just like most people, he/she will require surgery, blood tests, medications, and/or other medical procedures that can be quite costly. Many Veterinary procedures can run into thousands of dollars. You are aware of this, you will agree to this if your dog needs it, and your Vet recommends it. You attest that you can afford to do this.

Choose one:

Shelties and Collies can be VERY shy and skittish. They will panic and run away at strange noises or strange people. You must be extra cautious with a Sheltie, that they never get loose, or are able to slip out a door that gets left open. Once on the run, and in panic mode, they will not come to anyone, even an owner. You are aware of this and will take precautions to prevent this.*

Choose one:

You will commit to always keeping your new Sheltie on a leash, or in your fenced yard. You will never allow your Sheltie to run loose.

Choose one:

Because of a Shelties extreme shyness and skittish nature, if your Sheltie should happen to get loose and run away, it can cost hundreds to thousands of dollars to put up enough posters, take out multiple ads, and offer enough reward money, to recover the dog. The average time it takes to recover a lost Sheltie is 1 - 8 months. CISR requires that if your Sheltie gets loose, you contact CISR immediately and follow CISR's recovery program and instructions. You agree to take these steps should your Sheltie get loose.

Choose one:

Shelties are barkers and will react with barking to things like delivery people, the doorbell, etc. You are aware of this and will use only humane methods to train your Sheltie if needed.

Choose one:

Shelties are a double-coated breed and they shed once or more per year. To keep their coat and skin in good health, they require regular brushing and nail trims, as well as bathing and grooming as needed. You are aware of this and will be able to provide this care for your Sheltie.

Choose one:

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Your References
Please provide the names, addresses, and telephone numbers of two persons who can speak to the care you have given your present and past pets. Please indicate if either of those persons are family members, and do not include members of your immediate household.

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Return to Rescue
We place our dogs with the expectation that the adoption will be for the life of the dog. Please check any and all of the following circumstances that could cause you to return this dog to CISR.

A new job (longer hours, longer commute A divorce
A new baby Dog needs expensive vet care
Dog barks too much Dog bites someone
You move to a new house/residence Dog displays bad habits
Other (please explain below)
Please list any other circumstances that might cause you to return this dog to CISR.

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Fees and Costs
Please check below that you understand our fees and costs.

Puppies/Dogs up to 2 year of age:            $450
Adults 3-10 years of age:                           $400
Senior Adults 11+ years:                            $350
Your adoption fees allow CISR to provide the following services to all dogs in our program:

Treatment of any medical issue found
Spaying/neutering
One-year rabies vaccination
Distemper/Parvovirus combo vaccination
Heartworm test /or heartworm treatment
Heartworm preventive tablets
Flea prevention treatment
Intestinal worm treatment
Grooming
Dental cleaning
Extensive training for severe problems
Health Screen - Labwork.
Microchip and registration  (registration is done at time of adoption and is an extra $10.99.)
A medical history and all records.
A new leash and collar
I understand and agree to the fees and costs of CISR.

Choose one:

IF we have a dog that matches all your criteria (above)  we will begin by checking your references, including your Vet.
IF your references are good, the next step is someone from CISR will call or email you to set up a home visit.  We will come to your home and meet with you and your entire family, and view your fence and house?    Please make sure your entire family is in attendance.
You will receive a letter soon after your home visit with further instructions.
Note: If you do not hear back from us, it does not mean that you have been denied,   It simply means we do not have a dog that meets all the criteria that you listed in this application.

Please note: Submitting an application to CISR does not commit you to adopting a dog, nor does it mean you are sure to get a dog from us.  However, should you adopt a dog from us, this application, and ALL the statements you make in it, will be part of your adoption contract. Statements and/or answers to questions in this application are used in determining the suitability of a dog in your home. Therefore, providing false or misleading information on this application will be cause for terminating any adoption agreement we may make with you.

Please note that we have the right to refuse/reject any application for any reason at any time.

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Your Signature and Testament
ALL OF THE ANSWERS I HAVE GIVEN ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. I UNDERSTAND THAT IF ANY OF THE ANSWERS GIVEN ARE FOUND TO BE NOT TRUE AND CORRECT, AT ANY TIME, THE ADOPTION CONTRACT WILL BE NULL AND VOID, AND IF AN ADOPTION HAS OCCURRED, I WILL IMMEDIATELY RETURN THE SHELTIE TO CENTRAL ILLINOIS SHELTIE RESCUE. (Your electronic signature here is accepted as your full written signature.)

I would like to learn more about volunteering with Central Illinois Sheltie Rescue.

Choose one:

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