This site and rescue is dedicated to my late husband George who loved this rescue and all of the "kids". He is waiting at the Rainbow Bridge with all of the "paw prints" that went before him and those that went after.  With all my heart to him and this rescue, Susan
450 Gill Rd
Mifflintown, PA  17059
717-802-0789
 

Many will walk in and out of your life, but only a true friend will leave paw prints on your heart. ~Anonymous

  

SVCSR Adoption Form

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Susquehanna Valley Collie & Sheltie Rescue 

A Pennsylvania non-profit corporation

Adoption Request

ALL QUESTIONS MUST BE ANSWERED

 

NAME: EMAIL ADDRESS:

ADDRESS: PO BOX NOT ACCEPTABLE

CITY: STATE: ZIP: HOME PHONE:   OTHER PHONE:  FOR SECURITY PHONE NUMBERS WILL NOT APPEAR SO ENTER CAREFULLY

 

1.WHY DO YOU WANT A COLLIE OR SHETLAND SHEEP DOG?

2. HAVE YOU EVER HAD A COLLIE OR SHELTIE?  

3. IF YOU HAD ONE WHAT HAPPENED TO YOUR LAST DOG?

4 FOR WHAT PURPOSE DO YOU WANT THIS DOG?

5. DO YOU HAVE ANY OTHER ANIMALS IN THE HOME? PLEASE LIST TYPE AND AGE.

6. DO YOU HAVE ANY CHILDREN AT HOME? HOW MANY AND AGES?

7, DO YOU LIVE IN A:     8. DO YOU

9. IF YOU RENT DO YOU HAVE WRITTEN PERMISSION TO KEEP A DOG?

10. DO YOU HAVE A YARD?

11. DO ALL FAMILY MEMBERS WORK? IS SOMEONE HOME DAILY?

12. WHAT PROVISIONS WILL BE MADE FOR YOUR COLLIE OR SHELTIE IF NO ONE IS HOME DURING THE DAY?

13. DO YOU HAVE A GENDER PREFERENCE? 

14.DO YOU AGREE TO ASSUME THE FINANCIAL RESPONSIBILITIES OF CARING FOR AN ANIMAL , INCLUDING BUT NOT LIMITED TO INOCULATIONS, VETERINARIAN CARE, GOOD QUALITY FOOD, LICENSING ETC.? 

15. ARE YOU PLANNING TO MOVE IN THE NEAR FUTURE?   15A. IF QUESTION 15 IS NOT "NO" THEN EXPLAIN.

16. IS ANYONE IN YOUR HOME ALLERGIC TO ANIMALS?

17. WHAT CIRCUMSTANCES IN YOUR MIND JUSTIFY GETTING RID OF A DOG?

18. HOW DID YOU HEAR ABOUT SVCSR?

19. I ACCEPT AND AGREE THAT THERE IS AN ADOPTION DONATION FOR THE ADOPTED DOG AND THAT NORMAL DONATIONS AVERAGE ABOUT $200.

20. PLEASE PROVIDE YOUR VET'S NAME, ADDRESS AND PHONE NUMBER.

21. PLEASE PROVIDE A PERSONAL REFERENCE INCLUDING PHONE NUMBER.

22. SVCSR DOES NOT ADVOCATE DOGS BEING CHAINED OUTSIDE. WHERE WILL THIS DOG LIVE?

PLEASE VERIFY THAT YOU ARE OVER 18 YEARS OF AGE.  IF YOU ARE NOT PLEASE INCLUDE PARENT OR LEGAL GUARDIAN INFORMATION INCLUDING PHONE.

Susquehanna Valley Collie & Sheltie Rescue

450 Gill Road

Mifflintown, PA 17059

717-802-0789  

We reserve the right to refuse any applicant for any reason.  

Affer clicking "submit" you will ne taken to a conformation page which you may with to print. You can then return to this form using the link at the botton of the conformation page

 

 

Last time page edited: Tuesday, May 31, 2011 Site designed and maintained by: Acme Computer Service tech@acmecomputerservice.net Copyright 2001-2011 by SVCSR