Border Terrier Adoption Form

NABTW ADOPTION APPLICATION

Please complete this application and click “submit” at the end If you do not receive a response within 2 day, please contact sisque@msn.com If you would prefer to print the application to complete and mail it, please click here
DateName
Phone Number*
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
The following questions are not intended to be critical or judgmental. They are to help us place a Border Terrier with you. It might help you and us to realize a Border Terrier is not the right breed for you. When we place a dog in a new home, we want it to be a happy situation for you and your family as well as the dog. We also want the placement to be a permanent home for the life of the dog (Border Terriers can live 13-18 years). Any Border Terrier placed through NABTW must be returned to NABTW, if the owner can no longer take care of him/her. Please answer all the questions before submitting the form. There are no wrong answers so please respond honestly.
Have you lived with or personally owned a Border Terrier before?

YesNo
If the answer is “NO”, what made you choose a Border Terrier and what information did you use to learn about them?
Are you looking for a Border Terrier that you can work and/or complete with in any of the following activities?

Earthdog TestHuntingObedienceRally TherapyTracking A AgilityNose WorkFlyball
Do you have a strong preference for a male or female?

MaleFemale
If you do have a preference, please explain why?
It is rare to have puppies in rescue, mature adults and seniors are more usual candidates. Many Border Terriers remain active well into their teens, please indicate what age group you prefer (may select more than one)

PuppyYoung AdultMature AdultSenior
Are you willing to have an NABTW representative visit your home prior to any adoption?

YesNo
Please provide a reference of someone who knows you but is not a member of your household:
First Name Last Name Email Area Code Phone Number
Please list all household members, with their ages:
If you have children at home or who regularly visit you, please provide their ages and their experience with dogs:
Please provide information on any other pets you currently own. (Include information on shots and general health as well as the name and telephone number of your current veterinarian):
Please provide information on any dogs you’ve owned in the past and the circumstances under which they left the household:
How would you describe your home and surroundings:

HouseCondominiumRuralUrbanSuburban
Do you have a yard? If yes, please describe the fencing (Border Terriers can jump and dig):
If you have no fenced yard, how do you intend to exercise your dog and keep it safe while outside?
Is it important to you to allow your dog off-leash? Border Terriers have a strong “prey drive”. Extreme care is needed when they are off-leash.

YesNo
If you work outside the home, what is the maximum amount of time the dog would be left alone?
Where would leave the dog while you were of the home?

Free run of the houseConfined to a part of the houseCrated
Other, please specify
What plans do you have for your dog when you go on vacation?
Who will be the dog’s primary caregiver?
If you have any comments, questions or would like to tell us more about yourself:
There is an adoption fee which can vary from $200-$400. Are you willing and able to pay this fee?

YesNo
The NABTW contract requires that any dog adopted from them be returned, if you are no longer able to care for him/her.
Thank you for your interest in providing a forever home for a homeless Border Terrier.
Should be Empty:

NABTW ADOPTION APPLICATION