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Online Application Form
Use the following text blocks and check boxes to complete your application.
Please be sure to include your email address so that we can contact you.
Are you interested in adopting:
Would you consider adopting a Scottie Mix?
Would you consider adopting an older Scottie (over 8 years old),
a terminally ill dog, or a Scotty who has special needs (like
blindness, deafness, a medical condition such as Cushings that may
require daily attention)?
Would you take two Scotties?
Have you ever previously owned either a show or pet Scotty,
or had a Rescue Scotty? Please explain below.
Do you live in a:
Do you Rent or Own?
Do you have a fenced yard?
Do you have a pool or any other open body
of water anywhere on your property?
Please indicate the age of the primary caregiver.
76 - older
76 - older
Do you have minor children living at home?
Will this dog come in frequent contact with children?
Number of Adults in Household (over 18)?
Where will the dog stay during the DAY?
Where will the dog stay at NIGHT?
Typical Vacation Arrangements
Please list other pets you CURRENTLY own:
Your Veterinarian's Name (As a Reference):
Personal References (please provide two):