ISSDC Rescue/Rehome Adoption Application

Thank you for your interest in adopting a Shiloh Shepherd through the ISSDC Shiloh Shepherd Rehome/Rescue initiative. In order to be considered as an adopter you must:

• be 21 years of age or older;
• have identification showing your present address;
• have the knowledge and consent of your landlord, or alternatively, your family;
• be able and willing to spend the time and money necessary to provide training, medical treatment and proper care for a pet.

This form is an Adoption Application -- not an agreement to adopt a dog. We will use your answers as a starting point to work with you to determine whether or not a Shiloh Shepherd is really the dog you are looking for. If so, your completed application will provide the information we need to help you select a pet who will fit in well with your family, lifestyle and expectations.

The completion of this application is the first step toward approval as an ISSDC Shiloh Shepherd adopter. In addition, you should:

• Notify all references whom you list on this application, including veterinary clinics and private individuals giving them your permission to speak with an ISSDC representative when contacted
• Expect to be contacted by an ISSDC volunteer with additional questions that will help us in processing your application.
• Cooperate in scheduling a home visit, (with all members of your family present).

The ISSDC reserves the right to refuse to adopt to anyone.

*All fields required.

Name:

Address:

City: State: ZIP: Country:

Home Phone (with area code): Cell Phone (with area code):

Email:

You are: a student employed self-employed semi-retired retired

If employed, list your employer :

Work Phone:

Are you interested in adopting a:

Female
Male
Specific Dog
No Preference

If you are interested in a specific dog, please name the dog here:

Describe your home: House Condo Apartment Mobile Home Rural Property

You currently: live with parents rent own

If you rent or live with parents, provide landlord or parents name:

Landlord or parents phone number (with area code):

If you've been at your current address less than 1 year, please list previous address and how long you were there:

Do you have a fenced yard? Wood Privacy Wood Plank Electric Invisible Chain Link No Fence

Please give a detailed description of your current home:

Where will the adopted Shiloh Shepherd spend the day? (Describe in detail)

Where will the adopted Shiloh Shepherd spend the night? (Describe in detail)

How many hours per day or night will the adopted Shiloh Shepherd be left unattended? 1-3 3-6 6-9 9-12 12+

List all household members and their ages:

Member 1:

Member 2:

Member 3:

Member 4:

Member 5:

Member 6:

Please describe if anyone in your household has special needs or physical restrictions:

Do any household members experience allergies? Yes No

Is every member of your household in agreement on adopting a Shiloh Shepherd?: Yes No

Who will be primarily responsible for the daily care (excercise, feeding, training and grooming) of the dog:

Age of primary care giver?

Who will be responsible in the absence of the primary care giver?

Age of secondary care giver?

Do any members of the household have current or previous dog training experience? Yes No

If so, please describe this training experience in detail:

Are you planning to, or willing to work with a professional dog trainer? Yes No

Are all members of your household willing to follow the advice of a professional trainer? Yes No

List any pets/livestock you currently have, including their gender, age and breed(s):

Pet 1: - Spayed/Neutered?: Yes No

Pet 2: - Spayed/Neutered?: Yes No

Pet 3: - Spayed/Neutered?: Yes No

Pet 4: - Spayed/Neutered?: Yes No

Pet 5: - Spayed/Neutered?: Yes No

Do any of your current pets have any existing medical conditions? Please describe as accurately as possible:

If you do not currently have a dog, have you owned a dog(s) in the past?: Yes No

If so, describe the type of dog(s) you've had, how long you've had them and the reason you no longer have them:

Who is your current Veterinarian? (Name, address, phone number)

If this is your first pet, what veterinarian do you plan to use? (Name, address, phone number)

Are all your pets up to date on their vaccinations? Yes No No current pets

Are your pets currently on Heartworm Preventatives? Yes No No current pets

If so, which brand(s):

Why have you decided you want to adopt a Shiloh Shepherd?

You want to adopt a Shiloh Shepherd as: a family dog a personal companion dog a companion for a child a companion for another pet a protection dog a therapy dog a show dog

Please describe the details of your intentions and expectations of an adopted Shiloh Shepherd.

Some Shilohs come from great homes, are well adjusted, but have to be given up due to extenuating circumstances of their owners. Some Shilohs may come from abusive or neglective homes and will require diligent work on behalf of the adoptor to re-train the dog as a reliable companion.

You would prefer to adopt a Shiloh who: requires little to no effort needs some basic training requires a lot of TLC and professional training needs some serious rehabilitation needs a good home, whatever the effort

Are you willing to conduct a telephone interview pertaining to a potential dog? Yes No

Additional comments: