Courtesy Listing Form     (Please read our courtesy listing adoption policy here).
Instructions:
This form is provided for those wishing to list a Shiba on the Shiba Rescue web site.  To qualify for a listing, the dog should spayed/neutered before placement, and only modest adoption fees may be charged to recover rescue costs and maintain rescue finances.  This is not a service for those wishing to sell Shibas!!

If you wish to surrender your shiba to Midwest Shiba Inu Rescue, please go to http://www.shibarescue.org/surrender.html and fill out the release form. Email pictures of dog to be released to Intake Coordinator with name of dog in subject.

Please complete the form and press the submit button at the bottom (note: it may take a minute or two for the form to submit, after which a form acceptance screen from Freedback.com will display.  Please press the Submit button only once!).

Please include as much information as possible.  We will ONLY post listings that include images or photos (see below).

Remember to update your listing and to request removal when the dog has been adopted. Updates can be sent to listings@shibarescue.org.


Vital Statistics:
Dog's Name:     Shiba Inu Korean Jindo Mix Unknown
Age:     Color: 
Gender:    
Weight (lbs.):     Height (at the shoulder, in inches): 


Listing Type:
Please check the appropriate box to indicate whether this is a new Shiba listing or an update to an existing listing on the National Shiba Rescue site.

Listing Type: New Update Adoption Pending Remove

If "Remove," please indicate reason, comments etc.:

Dog's origin / history: Along with a brief explanation, if you're aware, please provide breeder name, pet-store name, shelter name, etc.  If the dog has papers, please indicate the certifying organization (AKC, UKC, etc.)



Contact Information:
This is the person to whom all correspondence and inquiries regarding this listing will be sent.  This should be a rescue volunteer or the owner of the dog up for adoption.  Please include a valid e-mail that you check regularly, as we will contact you on a monthly basis to determine the status of the dog in your listing.  If you cannot be reached by e-mail (or phone) then the listing will be removed!

                 I am: 

       Full Name:      
                              Include in listing: 
                    City:     State:     Zip: 
 Phone (home):     include with listing? NoYes
  Phone (work):     include with listing? NoYes
     Phone (cell):     include with listing? NoYes
                E-mail: 

include with listing? NoYes
                Preferred contact method:

Foster Information:
This is the person who is currently in possession of the dog.  Fill out this section only if the person fostering the dog is not the person listed as the contact in the section above.

      First Name:     Last Name: 
                             Include in listing: 
                   City:    State:    Zip: 
Phone (home):     include with listing? NoYes
 Phone (work):     include with listing? NoYes
    Phone (cell):     include with listing? NoYes
               E-mail:     include with listing? NoYes
               Preferred contact method:

If this dog has a web site, list the URL here:


Health:
Is the dog current on shots (rabies, DHLPP, etc)? NoYes 

Has this dog been spayed or neutered? 

Has this dog been tested for heartworm? NoYes

If yes, what were the results?

Health problems/concerns: 


Behavior:
Why is this dog in need of a new home (reasons for owner give-ups, etc.)?

1. Describe how this dog gets along with:

male dogs:   Comments: 
female dogs:   Comments:
cats:   Comments:
children under 8 years:   Comments:
teenagers:   Comments:
strangers:   Comments:


2. Has this dog ever bitten anyone?  

Please describe, in detail:
 

3. Rate the energy level of this dog: 

4. What are some of this dog's favorite activities or toys?


5. Does the dog prefer to be inside or outside? 

6. Does this dog bolt out of open doors? 

7. Is this dog a fence climber? 

8. Is this dog a digger? 

9. How does the dog respond to nail clipping and bathing?

10. How does the dog respond to loud noises?

11. Does the dog chew on inappropriate household items?

12. What are some endearing qualities of the dog?


Training:
1. Is the dog housetrained? 
2. Is the dog crate trained (can he/she be left alone in a crate)? 
3. Does the dog walk well on a leash? 
4. Has the dog had any obedience training? 

Details (commands known, etc.): 


Placement Info:
1. Are you willing to ship the dog if an appropriate home can be found in another area? NoYes   
2. Does this dog need a (new) foster home?  by what date:
3. By when does the dog need to be placed?
4. Adoption fee (if you wish to list it): 

Photos are necessary for a listing!
How will you be sending photos of this dog? Email  Mail

E-mail digital images, as attachments, to: listings@shibarescue.org, or e-mail for mailing address of standard photographs.


 Additional information/comments:


Created by: forms@shibarescue.org