Adoption Application
Adoption Application
First Name *
Your answer
Last Name *
Your answer
Email Address *
Your answer
Street Address *
Your answer
City *
Your answer
State *
Use state abbreviation
Your answer
Zip Code *
Your answer
Phone Number *
No dashes, just digits.
Your answer
What is the best way to reach you?
Please list specific dogs from our website that you are interested in. *
Your answer
What age of dog are you looking for? (select all that apply) *
Required
Would you consider adopting a mixed breed Australian Cattle Dog? *
What gender would you prefer? *
On average, how long will your new dog be left alone each day? *
Your answer
Please check any following special needs you would consider adopting. *
Required
Why do you want a cattle dog? *
Required
How many adults live in the home? *
How many children live in the home? *
Ages of children?
Your answer
What is your family's activity level? *
Your answer
How many pets do you have? *
Age(s)
Your answer
Breed/Species
Your answer
Gender(s)
Your answer
Are all of your pets spayed/neutered?
All dogs and cats in the home must be spayed/neutered prior to adoption. Unless for medical reasons the dog or cat can’t be spayed Heeling Heelers Hearts will need to see documentation from a licensed veterinarian.
Are all of your pets current on their vaccinations?
Please explain why your pets are not current on their vaccinations.
Your answer
Have you ever had to relinquish a pet (take to pound, give to friends,etc.)? *
Please explain why you had to relinquish a pet.
Your answer
Have you ever owned a Cattle Dog or mixed breed Cattle Dog? *
Please tell us your experience with the breed.
Your answer
What type of home do you reside in? *
Do you own your home? *
If you do not own your own home, can you provide us with a letter from your landlord granting permission to own a dog prior to adoption?
Is the backyard completely enclosed? *
What type of fence do you have?
Do you have a pool? *
Is the pool fenced?
Where will your new dog be kept while you are away? (check all the apply) *
Required
Where will your new dog sleep? (check all the apply) *
Required
We will not adopt to anyone that is going to keep their dog outside 24/7.
How will your new dog be transported in a vehicle? (check all that apply) *
Required
What would you do with your new dog in the case of a life altering event? This includes things like relocation, loss of employment, needing to provide hospice care for the dog, or development of dog allergies by a family member? *
Your answer
What would you do in the case of an incident involving your dog? This includes things like the dog developing destructive behaviors, getting in a dog fight, biting someone, or barking excessively. *
Your answer
Please provide the name and phone number of three personal references (that do not live with you) that we may contact.
Reference 1 *
Your answer
Reference 2 *
Your answer
Reference 3 *
Your answer
We thank you for your interest in adopting one of our dogs. Our adoption coordinator will contact you within two business days to discuss your application and further steps.
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