First Name
Middle Name
Last Name
Address
Address Line 2
City
State
Zip Code
Email
Cell Phone
Home Phone
Work Phone
Occupation
[For safety reasons, HSS does not place our Shelties in mobile/trailer home environments]
[Please attach the landlord's permission form above.] Allowed file types: docx, doc, pdf, rtf
If Other, please describe.
[Single dwelling homes must have a fence to protect sometimes nervous rescued Shelties that might tend to bolt.]
If No, please explain
[Our rescued Shelties must be kept in doors.]
If yes, what did the animal die of?
[HSS trusts that your children are experienced with and kind to animals. Please note: Because we cannot know all the personalities and behaviors of the children, HSS will not place our dogs in homes that have a baby sitting/day care home business.]
If yes, number
Ages(s)
[Due to the many health benefits accruing from spaying and neutering, as well as to prevent accidental litters, we require that all resident pets must be neutered/spayed. However, we do welcome knowledgeable, professional breeders who are members of the ASSA and their local breed clubs and who would like to work with our program to help our Shelites.]
Your Vet's Name
Your Vet's Phone Number
If Vet, Clinic, Pet Store, or Shelter Referral, Breeder, Dog/Obedience Club, or Another Rescue Group, list name. If Other, please explain.
Today's Date
Signature
Send