Northeast Shiba Rescue | Adoption Form

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Northeast Shiba Rescue Application for Adoption
	****Please Note: Because of the restrictions placed on us by the Massachusetts Dept of Agriculture we have retired from rescue. We are only accepting and responding to adoption forms for the Shibas currently listed on our website. For a list of Shiba rescues please click here. Name: Age: Street Address: City: State: Zip: Nearest big city to you: Home Phone: Best time to reach you: Place of Employment Occupation: Work Hours: How long with current employer: Email Address: Do you own or rent/lease your home? How long have you lived here? If rent/lease are dogs allowed? Landlord's name & phone number: Are you planning to move? Why do you want a Shiba? Who is this Shiba for? Does everyone want this Shiba? Who will be responsible for this Shiba? List names/ages of all household members: Anyone in your home have allergies to animals? Where will your Shiba spend the day? Crated, Loose Indoors, Basement, Garage, Outside Kennel, Fenced yard, Tied in Yard, Other Do you have a fenced in yard? Fence Height and Type: Is Fence in good condition and secure? If yard isn't fenced, how will the dog be exercised? Leash walks or cable run? Please list type, age, breed and gender of any currrent pets. Current Veterinarian's name, address and phone number: If prior dogs were owned, please list names, breeds, and tell us what happened to them. Please list behavior problems that would result in the return of a Shiba to us. Would you be willing to work with a trainer or behaviorist to resolve any behavior problems? Would you prefer to adopt: Male, Female or Either? Would you prefer to adopt: Puppy (under 1 year), Young Adult (age 1-3), Adult (4-8), Senior (9+) Do you have a color preference? Red, Cream, Sesame or Black and Tan? Which energy level best describes the type of Shiba you would like to adopt: Couch potato, Daily walks, Jogging/Hiking, Running/Energetic? Would you be interested in adopting a special needs Shiba? Are you willing to travel to meet a Shiba before adopting? If so, how far? Additional comments, questions or information that you would like us to know?

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