EmailMeForm
AUSTRALIAN SHEPHERD ADVOCATES ADOPTION APPLICATION
THANK YOU very much for your interest in adopting from Australian Shepherd Advocates (ASA)!
ASA is a nationwide, foster-based, 501(c)3 nonprofit dog rescue. As ASA is run by volunteers and the application process is as thorough as possible, please allow 10-14 days for processing (in some cases it may take longer).
*Applicants MUST BE 21 years old and over. We are unable to make exceptions to this.*
SOME IMPORTANT THINGS TO NOTE BEFORE APPLYING:
1. Please COMPLETE all aspects of the application. Applications WILL NOT be processed they are missing any information or found to have misinformation.
2. Please be sure to read the dog's description/bio THOROUGHLY before applying.
ASA knows the varied needs of each dog, which can sometimes be complex. We take great care in placing each dog, in order to do all we can to ensure a Happy Forever for both the dog and the adopter.
3. If you are not chosen to adopt the dog you applied for, it does not mean that you are not an approved applicant. Most likely, the dog either received many applications, or the rescue needs to continue to find the very best match possible based on what the rescue knows about their dog.
4. Applicants must be 21 years old and over.
5. All residents over 18 years old must be aware of and agree to the adoption of a dog. Therefore, we are unable to adopt out dogs to be "surprises" to other adults.
6. ASA is not able to adopt more than one dog at a time to an approved applicant.
7. The breed or mix listed for each dog is based on available knowledge and observation. It is not based on DNA or other analysis.
8. As a nationwide, foster-based rescue, we have many dogs in many states and therefore, cannot generally arrange meet and greets. Occasionally, exceptions are made depending on the dog's needs and location.
9. We do not move our dogs without approved placement and AFTER the Adoption Contract has been signed and returned.
10. The Adoption Fee is set for each dog and used for the veterinary needs and care of ASA rescue dogs.
11. Please let your veterinarian and personal references know they have your permission to speak to ASA representatives. Many veterinarians require express permission from you.
We appreciate the time and care you take in filling out an application. Thank you for choosing to rescue! ASA Team
AUSTRALIAN SHEPHERD ADVOCATES ADOPTION FORM
AUSTRALIAN SHEPHERD ADVOCATES ADOPTION APPLICATION
Date
MM
/
DD
/
YYYY
If applying for a specific dog,
Name of Dog applying for (if known) or description of dog.
*
Put N/A if not applying for a specific dog.
Full Name-Include your full legal first name and middle initial if you have one.
*
First
MI
Last
Address
*
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Antigua and Barbuda
Aruba
Bahamas
Barbados
Belize
Canada
Cayman Islands
Cook Islands
Costa Rica
Cuba
Dominica
Dominican Republic
El Salvador
Grenada
Guatemala
Haiti
Honduras
Jamaica
Mexico
Netherlands Antilles
Nicaragua
Panama
Puerto Rico
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Trinidad and Tobago
United States
Argentina
Bolivia
Brazil
Chile
Colombia
Ecuador
Guyana
Paraguay
Peru
Suriname
Uruguay
Venezuela
Albania
Andorra
Armenia
Austria
Azerbaijan
Belarus
Belgium
Bosnia and Herzegovina
Bulgaria
Croatia
Cyprus
Czech Republic
Denmark
Estonia
Faroe Islands
Finland
France
Georgia
Germany
Greece
Hungary
Iceland
Ireland
Italy
Kosovo
Latvia
Liechtenstein
Lithuania
Luxembourg
Macedonia
Malta
Moldova
Monaco
Montenegro
Netherlands
Norway
Poland
Portugal
Romania
San Marino
Serbia
Slovakia
Slovenia
Spain
Sweden
Switzerland
Ukraine
United Kingdom
Vatican City
Afghanistan
Bahrain
Bangladesh
Bhutan
Brunei Darussalam
Myanmar
Cambodia
China
East Timor
Hong Kong
India
Indonesia
Iran
Iraq
Israel
Japan
Jordan
Kazakhstan
North Korea
South Korea
Kuwait
Kyrgyzstan
Laos
Lebanon
Malaysia
Maldives
Mongolia
Nepal
Oman
Pakistan
Palestine
Philippines
Qatar
Russia
Saudi Arabia
Singapore
Sri Lanka
Syria
Taiwan
Tajikistan
Thailand
Turkey
Turkmenistan
United Arab Emirates
Uzbekistan
Vietnam
Yemen
Australia
Fiji
Kiribati
Marshall Islands
Micronesia
Nauru
New Zealand
Palau
Papua New Guinea
Samoa
Solomon Islands
Tonga
Tuvalu
Vanuatu
Algeria
Angola
Benin
Botswana
Burkina Faso
Burundi
Cameroon
Cape Verde
Central African Republic
Chad
Comoros
Democratic Republic of the Congo
Republic of the Congo
Djibouti
Egypt
Equatorial Guinea
Eritrea
Ethiopia
Gabon
Gambia
Ghana
Gibraltar
Guinea
Guinea-Bissau
Cote d'Ivoire
Kenya
Lesotho
Liberia
Libya
Madagascar
Malawi
Mali
Mauritania
Mauritius
Morocco
Mozambique
Namibia
Niger
Nigeria
Rwanda
Sao Tome and Principe
Senegal
Seychelles
Sierra Leone
Somalia
South Africa
Sudan
Swaziland
United Republic of Tanzania
Togo
Tunisia
Uganda
Zambia
Zimbabwe
Country / Region
Email
*
Confirm
Phone
*
###
-
###
-
####
Confirm
###
-
###
-
####
Date of Birth
*
MM
/
DD
/
YYYY
Is the address above where the dog will reside?
*If not, please explain why the dog will be residing at a different residence, and where you will be living.
*
If the dog will be residing at a different address, please give that address and zip code.
*
If this question does not apply to you, please put "n/a".
Do you own the residence where the dog will reside?
Yes
No
If you do not own the residence where the dog will reside, please provide the name and contact phone number of the landlord/manager, owner or HOA.
*
It this question does not apply to you, please put "n/a".
How long have you resided at your residence?
*
Please describe your residence. For example, single family home, townhouse, condo, apartment, farm/hobby farm, residence shared with roommates, etc.
*
Do you have plans to move within the next 6 months? If so, please explain.
*
If this questions does not apply, please put "n/a"
Name of Employer
*
If this question does not apply to you, please put "n/a".
Employment Status (Full-time, Part-Time, student, retired, self-employed, other) If "self-employed" or "other", please describe.
*
Have you ever personally owned an Australian Shepherd, Border Collie, or other herding or working breed dog?
*
Yes
No
If yes, please briefly describe the circumstances (breed, how long ago, how long did you have the dog, whether a family dog, or personal dog, etc.). If not, put "n/a".
*
If yes, please briefly describe the circumstances (breed, how long ago, how long did you have the dog, whether a family dog, or personal dog, etc.). If not, put "n/a".
*
Why do you want to adopt an Australian Shepherd or other herding/working breed dog?
*
What activities do you look forward to doing with a newly adopted dog?
*
Why are you interested in this specific dog?
*
Please put "n/a" if you are not applying for a specific dog.
Are you applying for a dog with special needs (i.e. hearing/vision impaired, seizures, etc)
*
Yes
No
*If you are applying for a dog with a specific disability this question MUST be answered.*
Please do not apply for a special needs dog until you have researched the specific needs of a dog with that disability, or can describe your experience with one.
Given the above, please briefly describe what you have learned about or the personal experience you have had with a dog with this disability.
*
Put n/a if you are not applying for a special needs dog.
*If you are applying for a special needs dog this question MUST be answered.*
In what ways have you prepared or will you prepare your home, and what changes will you make to your lifestyle to welcome a dog with special needs?
*
If you are not applying for a special needs dog, put n/a.
If you are not applying for a specific dog, or if the dog you are interested in becomes unavailable, please provide the breed, gender, and age range you are interested in.
*
Please put "n/a" if you are not interested in being considered for any other dogs.
If there is another ASA dog you are interested in, please list their name.
Do you have a fully fenced yard (4 sides)?
*
Yes
No
If yes, how tall is the fence? What type of fence is it?
Put "n/a" if not applicable.
If you have a pool, please describe it (above ground, below ground, fenced, etc.).
*
If this does not apply to you, please put "n/a".
Are you willing to consent to a home visit? (Please note: We cannot process this application without consent.)
*
Yes
No
Are you willing to consent to a background check? (Please note: We cannot process this application without consent.)
*
Yes
No
Are there other adults 18 years of age and older in the residence?
*
Yes. If so, please list below.
No
Please provide the following information for ALL other adults 18 years of age and older in the residence.
First name (Full legal)
Middle Initial
Last name
Date of Birth (month/day/year)
Relationship to you
Person
Person
Person
For additional adults over 18 years of age-list full first name, middle initial, and last name, date of birth (month/day/year) AND their relationship to you.
*
If not applicable, put n/a.
CHILDREN: Please give the age range of children under 18 years of age who LIVE IN the residence AND their relationship to you.
*
If not applicable, put n/a.
CHILDREN: Please list the age range of children under 18 years old who VISIT the residence frequently and their relationship to you.
Who will be the primary caretaker? *Please note: While we encourage children’s socialization with animals, we do not allow any children under the age of 18 to be the primary caretaker for any of our dogs. *
*
Will the dog live inside or outside of the home?
*
Inside
Outside
Where will the dog be during the day when the dog is home alone? Where will the dog be when the family is home? Where will the dog sleep? Please include your plans for crate training and/or free roaming in the house.
*
How many hours will the dog be home alone on a typical day? Please explain.
*
Have you ever surrendered or rehomed an animal?
*
Surrendered
Rehomed
No
If you have, what were the circumstances?
*
If not, put "n/a".
Please describe some examples of behaviors that would cause you to return a dog and what steps would you take before doing so?
*
Do you have experience in dog training, if so what techniques do you use? How do you/would you train your dog?
*
Have you ever been convicted of animal cruelty or neglect?
*
Yes
No
Do you currently pets/animals in the home?
*
Yes, please list below.
No
What current pets do you have, what are their ages, breed, sex, spay/neuter status? If you do not have any pets please put N/A for questions regarding pets.
Name
Age
Breed
Sex
Spay/Neuter
Temperament
Pet
Pet
Pet
Pet
Please list any additional pets/animals here.
We are unable to place our dogs in homes that have had a current dog for less than approximately 12 months. If you have recently adopted a dog within that time frame, please apply after you have had your dog for approximately 12 months. Thank you!
I have had my dog for approximately 12 months or longer.
*
Yes
No
I do not currently have a dog.
Are your pets up to date on vaccinations? Please note: All current resident dogs must be up to date on vaccinations and care for an application to be approved.
*
Yes
No
No current pets
Are your pets current on heartworm and flea and tick prevention?
*
Yes
No
No current pets
If yes which preventatives do you use?
*
If you do not currently have dogs, please list the name, breed, gender any dogs you have had previously (within the last 10 years).
IMPORTANT: It is the responsibility of the applicant to provide the required information to establish veterinarian care history. PLEASE make sure you have given your veterinarian permission to speak with ASA . We may not be able to call them again if you have not.
*
Veterinarian/Clinic Information
Name
Phone Number
Address
Name on account
Pet name
Veterinarian/Clinic
If your pets do not receive vaccinations or preventatives from the vet/clinic listed above, please provide the information of where the receive them below.
Name
Phone Number
Address
Name on account
Pet Name
Receive vaccinations or preventatives here:
If you do not have a pet currently, please list the information of the veterinarian/clinic you used previously (within the last 5-7 years). Call them to give ASA permission to contact them.
Previous Veterinarian/Clinic Information (within 5-7 years)
Name
Phone Number
Address
Name on Account
Pet Name
Veterinarian/Clinic
If you had not previously had a veterinarian, please provide the information of the vet/clinic you will use for your adopted dog.
Name
Address
Phone Number
Veterinarian/Clinic
Please Note: It is ASA's policy, as well as part of the Adoption Contract, that an applicant will not add another dog to their household within 12 months of adopting a dog from us. Do you consent to this?
*
Yes
No
* Are you familiar with MDR1, genetic multi drug resistance and Australian Shepherds? If not please reference this page: http://www.vetmed.wsu.edu/depts-vcpl/ *
*
Yes
No
PLEASE PROVIDE THREE NON-FAMILY, NON-VETERINARIAN PERSONAL REFERENCES-YOU MUST INCLUDE THE FIRST AND LAST NAMES. IF POSSIBLE, INCLUDE ONE PERSON WHO HAS SEEN YOU WITH DOGS/ANIMALS. *PLEASE LET YOUR REFERENCES KNOW THAT THE RESCUE MAY BE CONTACTING THEM ON YOUR BEHALF. WE WILL LEAVE A MESSAGE IF WE CANNOT REACH THEM, BUT MAY NOT BE ABLE TO MAKE SEVERAL REPEATED ATTEMPTS.
*
First and Last Name
Phone Number
Personal, Non-Family Reference
Personal, Non-Family Reference
Personal, Non-Family Reference
By printing your name below, you consent that all of the information above is true to the extent of your knowledge. You also understand that ASA cannot process applications that contain any inaccurate, incomplete, or missing responses, or misinformation. ASA is run by volunteers who donate their time.
*
Clear
