Application for Scottish Terrier Adoption

Please read and fill out carefully this application for adoption. This form was prepared for you, the prospective owner. Please be as thorough and accurate as possible. All forms will be kept on file for one year, after that any applicants still looking to adopt must re-apply with current information. Thank you for your cooperation.

Part I Personal Information

Name:______________________________________________________________________

Address:____________________________________________________________________

City:_________________________________________ State: _______Zip:_______________

Telephone (day)_________________________ (evening)_____________________________

Number of adults in household _____________ Men __________Women ________________

Children ____________Boys (ages ) ______ Girls (ages )________

What type of Dwelling: (Circle Appropriate)

Apartment/Apartment-Style Condominium Townhouse Duplex/Triplex

House-Trailer Home Farm Other(if other, please elaborate)

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Do you own or rent?_____________________________________________________________

If you rent, do you have the landlord’s permission to keep a dog?_________________________

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Part II, Environmental Information

How large is your yard? _________________________________________________________

Is it securely fenced? (if “yes” what kind and how tall?) _________________________________

What type of gates? ____________________________________________________________

Can children open the gates?_____________________________________________________

If the yard is not securely fenced, what type of improvements need to be made so that it is secure?______________________________________________________________________

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Are you willing to make such improvements? _________________________________________

If you have a pool, is it securely fenced? ____________________________________________

If you have a dog run is it secure? _________________________________________________

Are you aware of any dangers that could harm you dog inside the yard? ___________________

If your yard is not fenced, how do you plan to insure that the dog receives safe and adequate exercise? ____________________________________________________________________

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Can strangers gain access to your yard from the street? ________________________________

Where will the dog sleep? _______________________________________________________

Do you plan to keep the dog primarily indoors or out? Elaborate. _________________________
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Do you plan to use a Crate? Why or why not? ________________________________________

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Part III Pet History

Have you ever owned a Scottie before? _____________________________________________

How long? What happened to Him/her? _____________________________________________

Where did you get the dog? ______________________________________________________

Who is this Scottie for, self? For whom? ____________________________________________

Is anyone in your household allergic to pets? ________________________________________

Do you have other pets at this time? What kind and sex? ______________________________

Where did you get your pets? ____________________________________________________

How long have you had him/her? __________________________________________________

If you don’t have a pet now, have you owned one before? _______________________________

What kind and sex? ____________________________ How long did you have him/her? ______

What happened to him/her? ______________________________________________________

If you have other animals what has been your main problem(s) with them? _________________

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Why do you want a Scottie, as opposed to another pet? ________________________________

If you have other dogs, would you consider them aggressive or submissive to other people?___________________________________ Other animals?______________________

If you have birds, rabbits, cats, rodents etc., are you prepared to spend the necessary time to accustom them and the dog to each other? _________________________________________

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Can you isolate the dog from the other animals if they cannot get along? __________________

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Are you willing to take time with the acquisition of a Scottie, to read and learn all the facts of temperament, socialization, grooming and proper handling and understand the time required of the breed? __________________________________________________________________

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Part IV Behavior

What type of behaviors do you expect of this dog? ____________________________________

Name the most recent dog-training books you have read: _______________________________

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What amount of time and effort do you want to devote to training your Scottie? ______________

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Are you likely to enroll you dog in obedience class? ___________________________________

Which family members would be expected to assist in home training? _____________________

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What is your definition of disciplining a dog? _________________________________________

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What is your initial reactions to the idea of disciplining your dog? _________________________

What are your training objectives? _________________________________________________

What makes you a good pet owner? _______________________________________________

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Part V What Type of Rescue

Color Sex and age preference: ____________________________________________________

Would you consider the opposite sex? ______________________________________________

Would you be interested in an older dog? ___________________________________________

Would you be interested in a young adult/puppy? _____________________________________

Are you agreeable to returning the dog , should unforeseen circumstance arise where in you would no longer be able to keep the dog? ___________________________________________

Would you be willing to allow us to visit your home? ___________________________________

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Part VI Family information

Have you discussed with your family the pro’s and con’s of owning a Scottie? _______________

Have you asked yourself weather your lifestyle is so busy that you might not have the time or energy to properly care for a dog? _________________________________________________

Is your lifestyle such that friends, relatives and children gain admittance to your home, property, and car without your supervision? _________________________________________________

If you have children, are you willing to accept the additional responsibility of a Scottie? _______

Have you taught your children the proper way to treat a living animal? _____________________

Does everyone in your family want a dog? ___________________________________________

What other breeds have you been contemplating? ____________________________________

What is your family’s overall reaction to owning a dog? _________________________________

Which members are enthusiastic? Unenthusiastic? ____________________________________

What concerns have been voiced by other family members? ____________________________

Do you realize that Scotties can live upwards of 15 years, and are you committed to care for it that long? ___________________________________________________________________

Is there anything else that you want to tell us about your family and its suitability to adopt a rescue Scottie? _______________________________________________________________

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How did you find out about us? __________________________________________________

Your comments or suggestions: ___________________________________________________

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Part VII References

Please list three references that can attest to your suitability as a pet owner, and more specifically, the owner of a Rescued Scottie. If you own any pets now, you may include your Veterinarian as a reference.

Reference #1

Address:

City, State, Zip

Phone: (day and evening)

Reference #2

Address:

City, State, Zip

Phone: (day and evening)

Reference #3

Address:

City, State, Zip

Phone: (day and evening)

I, the undersigned, attest that , to the best of my knowledge the above information is accurate and complete at the time of signing, and I understand that falsely provided information can mean that my application will be terminated.

Signature Date

Thank you for your cooperation, this comprehensive questionnaire helps us in placing the right dog with the right family. An improper placement or one in which all the details aren’t known, can end tragically, usually for the dog. Thank you again!