{form:RMSR Adoption Application and Contract Form}

About You

Applicant's Name *

First Last

Spouse's / Partner's Name

First Last

Street Address *

Street Address City State / Province / Region Postal / Zip Code

Your Phone # (include best time to call) *

Email *

Applicant's Age *

You must be at least 21 years of age to adopt a rescued Scottie.

Your Occupation *

Spouse's / Partner's Occupation

About Your Home Environment

What type of dwelling do you live in? *

Do you own or rent? *

Own

Rent

If renting/leasing, documentation allowing dogs on the property is required.

Do you have a fenced yard? *

Yes

No

Can the fence gate be locked? *

Yes

No

Describe the approximate height & type fence. Describe the outdoors area where the dog will be. *

Does a door from the house open directly to the fenced yard? *

Yes

No

Describe your location. Example: quiet suburban neighborhood, wooded hillside home, busy inner city street, etc. *

Do you live by any large body of water (i.e. lake, reservoir)? *

Yes

No

Do you have a swimming pool? *

Yes

No

About Your Family

List all household members, other than yourself, their ages and relationship. *

Enter NONE if there are no other household members.

List animals in your household. Include species, breed, age, and sex. Indicate spayed/neutered. *

Enter NONE if there are no animals in your home.

Will the Scottie come in contact with children not living in your home? *

Yes

No

Maybe

Ex.: grandchildren, visiting relatives, etc.

If you answered "yes" or "maybe" above, please explain.

Do all family members want a Scottie? *

Yes

No

Who will be the primary person responsible for the Scottie? *

Have you previously been owned by or lived with Scotties? *

Yes

No

If you answered "yes" above, please explain.

Are you aware of the grooming needs and associated expenses? *

Yes

No

Are you aware that Scotties can pose a clean house challenge with their "velcro" coats and wet beards? *

Yes

No

Have you ever attended dog obedience classes? *

Yes

No

Have you trained other animals besides dogs, like horses? *

Yes

No

Are you aware of your need to be a strong "pack leader" for your Scottie? *

Yes

No

Briefly, provide your definition of a Scottish Terrier. *

Why are you interested in obtaining a Scottie? *

Scottie Preferences:

Sex: *

Age Range: *

***** We rarely see Scotties enter rescue that are less than 1 year old. *****

Color: *

Would you consider a Scottie Mix? *

Yes

No

Maybe

Would you consider a bonded pair of Scotties? *

Yes

No

Maybe

Would you consider adopting more than one Scottie? *

Yes

No

Maybe

Would you consider a dog with minor behavior problems? *

Yes

No

Maybe

Would you consider a dog with minor health problems? *

Yes

No

Maybe

The Scottie

Where will the dog stay at night? *

Is someone home during the day? *

Yes

No

If you answered "no" above, please explain where the Scottie would stay. Include the approximate number of hours the Scottie would be alone each day.

Describe a normal day in your household. *

Will the Scottie have the run of the house when you are home? *

Yes

No

Describe your plan to provide your Scottie with exercise. *

What will you do if your Scottie marks in the house? *

What arrangements will be made for the Scottie during extended absences? *

Have you ever given up a dog to a shelter or rescue? *

Yes

No

You would consider giving up a dog if: *

What are your plans for the Scottie should you suddenly become incapacitated or pass away? Identify who will be responsible for the Scottie in case of an emergency or if, for any reason, you can no longer care for the Scottie? *

Have you considered establishing a pet trust fund? *

Yes

No

References

List 3 personal references.

Personal Reference #1 *

Include name, address, phone #, & relationship.

Personal Reference #2 *

Include name, address, phone #, & relationship.

Personal Reference #3 *

Include name, address, phone #, & relationship.

Do you currently have a veterinarian? *

Yes

No

If Yes, please enter the veterinary information below.

Veterinarian's Information

Include vet's name, clinic name, address, & phone #.

Do you currently have a groomer? *

Yes

No

If Yes, please enter the groomer's information below.

Groomer's Information

Include groomer's name, business name, address, & phone #.

How did you learn about Rocky Mountain Scottie Rescue? *

Please use this area to add any other information you wish us to consider in placing a Scottie with you.

Please include any previous pet experiences as well as your expectations for sharing your life, home, and family with a rescue Scottie.

Rocky Mountain Scottie Rescue, Inc. (RMSR) reserves the right to refuse any applicant(s) if any of the statements submitted in the Adoption Application and/or Release of Liability and Indemnification are found to be fraudulent and/or untrue; we reserve the right to repossess the Scottie and all liabilities are waived. Submission of an application does not imply nor guarantee that the applicant will adopt a Rescue Scottie. The submission of an application also does not imply nor guarantee that the "right" Scottie will be available for adoption through RMSR. RMSR has the right to refuse adoption to any individual(s) for any reason it sees fit.

Do You Agree to the Adoption Terms and Conditions? *

Yes

Click above if you have read and agree to the Adoption Terms and Conditions.