Adoption Application
Please do not submit this form if you are not serious in adopting a Cattle Dog or Cattle Dog mix. Incomplete applications wil not be processed or responded to. Make sure to research this breed to ensure they are a good fit for your home, family and lifestyle. * are required to be answered and the form will not submit without them. Thanks!
Name *
Email *
Main Phone *
Secondary Phone *
Street Address *
City *
State *
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Zip Code *
What are you major cross streets?
If you are not in the States, please indicate where you are here:
What age of dog are you looking to adopt? Puppy (8 weeks to 6 months) Adolescent (6 months to 2 years) Adult (2years to 8 years) Senior (8 years plus)
What color do you prefer? Red Blue No Preference
What Gender are you looking for Male Female No Preference
Would you consider an Australian Cattle Dog mix or other Herding type dog? Yes No Maybe
Is anyone in your household allergic to dogs? * Yes No
How many Adults live in the home? *
How many children live in the home? *
What are their ages?
Has everyone in the home agreed to add a dog to the family? Yes No
If you answered No above, then please explain why?
Do you currently have pets? * Yes No
If you answered yes above, please list the (1)Name, (2) Sex, (3) Age and (4) Breed of every pet in your household.
Are your pets all current on their vaccinations? (Distemper-Parvo, Bordatella, Rabies) * Yes No
Are your pets altered (spayed or neutered)? Yes No
If your pets are not altered or not up-to-date on vaccines, please explain why:
Do you have a Dog Door? * Yes No
If you don't have a dog door, would you consider installing one? Yes No Maybe
If you answered No above, please explain why.
Do you have a Pool? * Yes No
If you have a pool, is it fenced? Yes No
Do you own your Home? Yes No
If you do not own your home, can you provide us with a letter from your landlord saying dogs are allowed at the residence? Yes No Maybe
What type of Residence do you live in? * Single Family Home – Tract Home w/fenced back yard Single Family Home – Tract Home w/no fenced back yard Single Family Home with Land Mobile Home in Park Mobile Home/Modular with Land Apartment/Condo/Townhome with Yard Apartment/Condo/Townhome without Yard
Is the back yard completely enclosed/fenced? * Yes No
What type of fencing (chain link, no climb, block, wood) and approximately how tall? *
Would you consider adopting a special needs dog? * Yes No Maybe, Would like to learn more
What types of Special Needs are you willing to consider for adoption (please check all that apply)? Deaf Blind Hearing Impaired Sight Impaired Fear Aggressive Dog-Dog Aggressive Cat or Small Animal Aggressive Not good with Children In Need of Obedience Training Dominance Issues Medical Care Needed Requires ongoing Prescription Meds or Vitamin Supplements Has Seizures Special Training Required I'd like to learn more
How long will your new dog be left alone during a typical day? * Minimal-I Stay or Work From Home 0 Hours 1-3 Hours 3-6 Hours 6-9 Hours 9 Hours Plus I work two Jobs
Where will your new dog be kept while you are away? Inside Only – free run of house Outside only no access to house Inside/Outside with dog door Crate Outside Kennel or Run Outside Cable or Chain Laundry room or other small room Garage access only Free Roaming
Where will your new dog sleep? * Inside Only – free run of house Outside only no access to house Inside/Outside with dog door Crate Outside Kennel or Run Outside Cable or Chain Laundry room or other small room Garage access only Free Roaming
Are you familiar with Crate Training? * Yes No I'd like to learn more
Are you willing to have a New Hope Cattle Dog representative/volunteer visit your home before adoption? * Yes No
If you answered No to having someone visit your home, please explain why not:
Are you willing to take your new dog to Obedience Classes? * Yes No Maybe
If opposed to taking your dog to Obedience Class, please explain:
Why do you want a Cattle Dog or a Herding breed mix? *
Have you ever owned a Cattle Dog or Cattle Dog/Herding Breed mix? * Yes No
If you have owned a Cattle Dog or Cattle Dog mix, where are they now?
If you have never owned a Cattle Dog or even if you have, please relate your experiences with the breed: *
What Research have you done on this breed (please check all that apply)? * None Read ACD FAQ by Mark Abbott Researched History of Breed Have Owned Breed or mix Read Books specifically about breed Have trained breed Have shown breed Have read articles from Cattledog.com Have read New Hope site from top to bottom Have read article(s) from other websites Please send more info
Please describe what a typical day in the life of your new dog: *
Who is your current Veterinarian (please include Vet Name, Clinic Name, Address and Phone number)? *
Can we contact your Veterinarian for a Reference? * Yes No
What type of Dog are you looking for (please check all that apply)? Working Dog Agility Competition Fly ball Competition Personal Protection Search and Rescue (Tracking) Other Competition Companion for Child Companion for Adult Companion for Pet Dog to go to work with you Best Friend Outside Only (Back yard)dog
What kind of activities do you and your family participate in regularly that the new dog would be involved in (please check all that apply)? * Hiking Bike Riding Camping Running or Jogging Walking Dog Parks Play Dates w/other dogs Movies or TV watching Traveling via RV Traveling via Airplane Boating Home Schooling or Daycare Activities with Kids Dog Sports Dog Training
How would you rate your family’s overall activity level? * Never Active Active 1-2 times per week Active 3-4 times per week Active 5-6 times per week Active Daily Active only on Weekend
How do you plan on transporting your dog in your vehicle (please check all that apply)? * I don't plan to transport Open Bed of Truck Free in Backseat Crated in Vehicle Tethered/Tied/Chained in Open Bed of Truck Free in Enclosed Bed of Truck Seat belted in vehicle
What do you plan to do with your dog in the event of a Divorce or separation with your significant other? *
What would you do with your pets if you had a family member or significant other that became allergic to pets? *
What would you do with your pets if you, your spouse or significant other had a Job Transfer to a different state? *
What would you do if unemployment or a financial difficulty arose that forces you to move into smaller home or apartment? *
What would you do if the new dog is destructive in your home or yard? *
What would you do if your neighbors complained that your dog barks excessively in the backyard or house *
What would you do if your dog needed emergency surgery or care over $1000? *
What would you do if your dog needed Hospice Home or Long term care (i.e. help going to the bathroom, help eating, IV Fluids, Injections, etc.)? *
What would you do if your dog bites someone? *
What would you do if your new dog bites you? *
What would you do if your new dog fights with other pets in your home or new pets brought into your home? *
Have you ever had to relinquish a pet (i.e. take to the pound, give to family/friends)? * Yes No
If you answered Yes above, please explain the circumstances:
Have you ever been involved in breeding dogs? * Yes No
If you answered Yes above, please explain:
What are the specific names of the Dog (s) from our website that you are interested in? (please list all). *
How soon are you looking to adopt? * Today Within a week Within 1-2 weeks Within 3-4 weeks Within 1-2 months Next Year
Are you working with other rescue groups/shelters? * Yes No
Please tell us what days and times work best to schedule a home check: *
We need 3 personal references that have seen or know how you treat your animals. Please list their full names, phone numbers and email addresses so we may contact them. *
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