Collie Rescue of Western PA, Inc.
P.O. Box 97046
Pittsburgh, PA 15229
Tel: 412-364-5742
info@collierescuewpa.org
Collie Rescue of Western Pennsylvania, Inc.

Adoption Application

Thank you for considering adopting a Collie from Collie Rescue of W. PA. It is our intent to place Collies into loving, responsible homes that will benefit both the dog and the adoptive family. We use your responses on the application as part of our evaluation process. Please complete the application below (scroll down if not visible).

Please complete all information. Fields marker with an asterisk (*) are required.

   
Name*
Address*
City*
State*
ZIP Code*
Phone*
Email*
Occupation
Why do you want a collie?
 
Have you ever owned a dog before?
 

Yes
No
Was it a Collie? Yes. If not, what breed:

What happened to your last dog?
 
Please list your Current Pets
 
Species
Breed
Age
Sex
Spayed or Neutered
Yes No
Yes No
Yes No
Ages of Children in Household?
 
Child #1
Child #2
Child# 3
Child #4
Child #5
Child #6
Do You?  
  Own
Rent
Live With Parents
  If you rent, does your landlord permit you to have a large dog?
Yes No
Landlord's name and telephone:
  Do you have fenced yard? Yes No
If yes, type/height
Do you have a Kennel Run? Yes No
If not, do you intend to fence your yard?
Yes
No; When
  If you do not have a fenced yard and do not intend to fence it, how do you plan to exercise your
Collie?
Is any member of your household allergic to animals?
  Yes No 
Does every member of your household want a dog?
  Yes No  
Will your Collie live....
  Indoors
Live Outdoors  
Do you perfer ....
  Male
Female   
 No Preference
Which color do you prefer...
 
Sable (like Lassie)
Blue Merle (silver blue/gray)
Tricolor (black)
White
No Preference
Are you aware ...
  That Collies are large dogs, weighing from 45 to 90 lbs?
Yes No 
  That Collies are herding dogs and may chase (herd) children, bikers, joggers, cars and trucks?
Yes No 
  That Collies require regular grooming and shed a lot?
 Yes No  
Smooth Collies have short coats, but have the same coloring and markings as a Rough Collie.
  Would you consider a Smooth Collie?
 Yes No 
What age dog would work best for you?
  Under a Year (we rarely have puppies)
Older Dog. How old is too old?
Would you consider a senior (8+ years) Yes No 
How energetic do you want your dog to be?
  Gentle
Fairly Active
Very Active
 Where will your dog be kept ...
  During the day?
  At night?
How many hours will the dog be alone each day?
 
Are you interested in obedience training?
  Yes
No 
Are you interested in competition training?
  Yes
No 
Veterinarian's Name and Telephone
  Name:
  Telephone:
If your life circumstances change, what would you do with your dog?
 
How did you learn about Collie Rescue of W. Pa?
 
   
 

 

 

Your adopted Collie will have been professionally groomed and will have had:

A complete physical examination by a veterinarian
A DHLPP vaccination
A Rabies vaccination
A Heartworm test (preventative will accompany the dog)
Spay/Neuter

Your dog will be wearing a new collar, Collie Rescue Identification tag and a new 6' leash.

Thank You!
We Look Forward to Meeting You!