Australian Shepherd Rescue of St. Louis
http://aussierescuestlouis.com
314-740-2592 - Kay@aussierescuestlouis.com
Adoption Application
We do allow long distance adoptions, but adopters must agree to travel to the St. Louis area in order to meet
the prospective dog. All adoptions are based on the compatibility of the adopter and adoptee.
Your answers on this application will help us to find the best possible match between you and the dogs in our care. The more we know, the better we are able to make each adoption successful. All information is confidential. Thank you for your cooperation and help answering our questions. (If no phone number is given, this application will be discarded.)
Name
Address
City
State
Zip
Home Phone
Work Phone
Cell Phone
E-Mail address
Occupation
How long at present job?
References:
Employment
Neighbor
Address
Address
Phone
Phone
Do you own or rent your home?
How long have you been at this address?
If less than 1 year, please list previous address
Name and telephone of Landlord if renting
Does your landlord agree to you having a pet?
Do you have a fenced yard or area for the dog?
If yes, please describe your fence
If not, what arrangements will you have for the dog's exercise and toilet duties?
If married, does your spouse approve of getting this dog?
How many adults in the household?
How many children?
Age and sex of children
How many dogs have you owned in the past 10 years?
If you no longer own them, please describe what happened to them
Do you own cats?
How many?
Type, age and sex of each pet
How many are neutered/spayed?
Describe any other animals you own
Name of current veterinarian
Address
Phone
Where will the dog spend the day?
Crate
Basement
Garage
Fenced Yard
Kennel
How many hours a day will the dog be alone?
Where will the dog sleep at night?
What is your preference in a dog?
Male
Female
Under 1 yr
Under 2 yrs
2 yrs or older
No Preference
Color
List all plans for this dog
Pet
Guard
Hunting
Obedience
Herding
Agility
Other
If you have never owned an Aussie before, why do you want to adopt one now?
What qualities do you like in this breed?
What don't you want to find in this breed?
Would you be willing to have our representative visit with you in your home before adopting a dog?
Do you understand that the dog is required to be spayed or neutered?
Do you agree to give the dog regular health care?
Do you agree to contact us if you can no longer keep this dog?
How did you hear about our rescue work?
Approved applicants who receive a "RESCUE" dog are required to pay $200 adoption donation.
Thank you for your interest in our non-profit 501c(3) volunteer organization.
Signature of Applicant
Date
Signature of Co-Applicant (if any)
Date
Click below to send by email:
If mailing please print and return this signed application to:
Australian Shepherd Rescue of St. Louis
1716 Shiloh Valley Drive
Wildwood, MO 63005
314-740-2592