At Central Illinois Sheltie Rescue (CISR), we are looking for the best and last home for each of our dogs. We do not feel that “any" home is better than no home. We are only looking for homes that:
If this describes you, please continue below!
Privacy note: This information is for private use by CISR and will never be made public. We do not share or sell your e-mail or other information.
Note: This application will take 20-30 minutes to complete. Please take your time, and make sure you answer each question in detail. This is our first introduction to you, and we are looking for complete, well-thought-out answers.
*****Applications that have missing answers will not be processed.
*****Applications with one-word answers, and no insight as to your thoughts, will not be processed.
First Name*
Last Name*
Address*
City*
State/Province*
Zip/Postal Code* -
County*
Email*
Home Phone*
Work Phone x
Cell Phone*
Alt Email
Text/Pager Email
Which dog are you most interested in?* Choose an animal: Any Dog that needs me Daphne Dusty Kiri Lilly Millie Pebbles Percy Ryker Sir Pepper Summer Valen
Do you have an application pending with any other rescue group for another dog?* Choose one: Yes No
Please list the name and ages of everyone living in your home.*
If there is a co-applicant, please provide their name and date of birth.
Name of your employer
Spouse or partner or co-applicant's employer
In what type of home do you live Choose one: Apartment Condominium Duplex Live with other Military Housing Mobile Home Other Single Family Townhouse Live with parents
How often do you have children (10 or under) visiting your home?
Please list the ages of everyone living in your home
Do you own or rent your home? Choose one: Rent Own
Does ANYONE in the house smoke inside? Or JUST outside?*
Do you know this breed well? Or have you researched this breed? Please explain your knowledge of this breed....
How much time per day are you able to devote to training and interacting with this new dog?
How much time will the animal spend alone during the day*
Have you ever successfully boundary trained a dog, so that it would not run off if it was loose? Please explain
Please list all of your CURRENT Pets. Please use this format. Name / Breed / Age / Weight / Fixed? / Microchipped? / Date acquired? /
Please list of all your PRIOR Pets. Please use this format: Name / Breed /Dates Owned / Cause of death or Rehoming
Is your yard fully fenced in, with a physical fence that a small animal could not escape from?
Your fence is (check all that apply)
Approximately how many square feet does your fence enclose?
What is the height of the fence*
Does an exit from your home lead DIRECTLY into the fenced yard? Choose one: Yes No Must go through the garage
The fence condition? Secure? Good condition? Reaches all the way to the ground? No holes or gaps
If you would ever allow this dog to be off it's leash in an unfenced area, please explain under what conditions?
Where will the animal be kept when you are home
Where will the animal be kept when you are not home
Where will the animal sleep
Do you allow dogs to sleep on your bed with you? Choose one: Yes No
Are dogs allowed on your furniture?
Do you have a Doggie Door?
What do you plan on feeding your dog?
What kind of treats have you given (or will give) your dogs?
Please list your CURRENT veterinarian information (name, address, phone number).
Do you give CISR permission to speak to your veterinarian as to the care you give your pets? Choose one: Yes No
Please list your PAST veterinarian information (names, addresses, phone numbers).
Do you give CISR permission to speak to your past veterinarian as to the care you give your pets? Choose one: Yes No
Have you ever given up a pet? If yes, please explain
Have you ever had a pet stolen or lost? If yes, please elaborate.
Have all your current and past pets been microchipped? (If no, please elaborate.)
Have you ever had a pet hit by a car? (If yes, please elaborate.)
Have you ever bred any of your dogs? If yes, please elaborate.
How often do your pets receive a full physical exam from your veterinarian?
Are you aware that dogs (especially small dogs) need frequent dental cleanings by your Vet?
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.
Please check below that you understand our fees and costs.
Your adoption fees allow CISR to provide the following services to all dogs in our program:
I understand and agree to the fees and costs of CISR. Choose one: Yes No
Please tell us anything more you would like us to know about you?
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.)