Adoption Application

If you are interested in a rescue collie please take the time to fill out this application.  This helps better  know you so we can insure these collies get the home and love they deserve.

Tell us about yourself

Name:

Email

State

Zip

How long here?

Home Phone

Work Phone

Best Place to Call

Best Time to Call

Are you over 18 years old?

Tell us about your home

Tell us how you will care for your rescue collie

Can you provide:

  •  annual vet  and shots ($40.00 a year)?

  •  monthly heartworm and flea control ($15 a month)?

  •  lots of love and patience (priceless)?

 

Why are you interested in a collie?

Where do you live?

Own or Rent?

Type of  dwelling

Number of people in household

 Number younger than 18

Ages  of children under 18

Fenced Backyard?

Type of Fence

Height

Tell us about your pets

How many pets  have you owned in the last five years?

How many dogs ?

How many cats ?

Others? (include type &  number)

Where  did you get these pets?

What happened to those pets you no longer have?

Are all dogs current on shots

Do you use heartworm preventative?

Is your family aware of your decision to bring a collie home?

Are you willing to care for this collie for its entire life (up to 15 years)?

Do you object to home visits by Collie Rescue of Mississippi ?

Are you willing to contact Collie Rescue of Mississippi if you can

no longer keep the collie?

Where will the collie live during the day?

Where will the collie sleep at night?

Anything else you would like us to know when considering your application?

Last updated 10/14/02

© 2000 –  Collie Rescue of Mississippi

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I certify that my submissions above are correct to the best of my knowledge.

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