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We adopt only to California residents.

We strongly prefer that you use the online web form below, but a printable form is available for mailing or faxing. The form is available as a PDF (portable document format). To read or print a PDF file, you will need Adobe's Acrobat program, which is free of charge. To continue our work, we hope you might help us by making a donation so we can help other Australian Shepherds in need.

Adoption Application
The answers you give on this application will help us to find the best possible match between you and the dogs available through NorCal Aussie Rescue, Inc. We suggest you read About Aussies: Is an aussie right for you? before filling out the application. Please fill out the form completely. This form cannot be processed without a phone number.

* Name
* Home Phone * Work Phone
* Email
* Address
* City * State * Zip
Name of a Personal Reference
(not a family member, please!)
Phone Relationship
Do you own or rent your home? Own Home    Rent
If you rent, do you have your landlord's permission to keep a dog? Yes    No
Landlord's Name Landlord's Phone
Do you live in a...
House    Apartment    Trailer   
Other:  
How long have you lived at this address?
Do you have a fenced yard? Yes    No
Fence Height Fence Type
Do you have a separate kennel run? Yes    No
Kennel Height Kennel Size
How many adults in household? How many children?
Age and sex of children
(if applicable)
Are there regular visitors to your home (human or animal) with which your new dog must get along? Yes    No
If so, please describe
If you have livestock or farm animals, please list the types
Do you own other dogs? Yes    No
If so, which have been neutered/spayed?
Give breed, sex and age of each
Do you own cats? Yes    No If so, how many?
Do you own other animals? Yes    No
Name of regular Veterinarian
Vet Phone
Vet Address
City State Zip
How many dogs have you owned in the last five years?
List breeds and indicate if you still
own the dogs
For dogs you no longer own, what happened to them? (please be specific)
Have you owned an Australian Shepherd before? Yes    No
Why do you choose the Australian Shepherd?
Plans for this dog...
Pet    Guard    Hunting   
Herding    Agility    Obedience   
Other:  
How many hours a day on the average will the dog spend alone (without humans)?
Where will the dog spend the night?
Loose Indoors    Crate    Basement   
Garage    Fenced Yard    Kennel Run   
Tied up outdoors    Loose Outdoors   
Other:  
How active a dog are you looking for? Above Average Activity Level
Average Activity Level
Below Average Activity Level (couch potato)
If you are interested in a particular dog, which one?
And if so, where did you hear about the dog? (please be specific)
If you are already working with a particular rescue rep, which one?
Do you understand this dog must be spayed or neutered? Yes    No
Do you agree to license this dog and give regular health care? Yes    No
Do you agree to contact NorCal Aussie Rescue if you can no longer keep this dog? Yes    No
Would you be willing to let a representative visit your home by appointment? Yes    No
If not, why not?
Describe your ideal Aussie and what types of activities you would do with him/her:
How did you hear about us?
**To verify you're a human: I have a sister named Liz and a brother named Tom. Which is my female sibling?
By submitting this application, I declare that all of the above information I have given is true and complete.
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