Midwest Border Collie Rescue Adoption Application

Is your property fenced? If so, please list the type and height of your fence. Fence not always required. Fence need is dependent on the dog.*

If not fenced, please describe how you will provide your dog with adequate exercise. (Please be specific)*

What activities or work will the Border Collie have outside of your home, if any?*

Will your dog be living with or have any of these neighbors/visitors or encounter any of these situations on a regular basis? Check all that apply.*

Who will provide the majority of care for this pet? *

Where will the dog sleep at night?*

Where will the dog spend its time alone during the day?*

Do you have a second home/vacation home?*

YesNo

If yes, please describe where it's located, how often you visit and the type of environment.

Describe a typical day/week for your dog. When will the dog be alone, what would its typical daily activities and schedule be? Note: if you do not have a dog, please note that and describe what you would envision for a typical day or week. *

Have you ever participated in an obedience class?*

YesNo

Do you plan on enrolling you new dog in obedience class?*

YesNo

When your dog arrives, how long so you feel they will need before they adjust to their new surroundings?*

How do you feel about using dog crates?*

When you go on vacation, where will your dog go and who will care for it? If you move, what will you do with your dog?*

What behaviors would you have a hard time dealing with?*

Please list all of your current household pets. (Include Name, Type, Sex, Age, Neutered/Spayed)*

If you do not currently have a dog, how long since you have owned one?*

What conditions or circumstances would cause you to give up a dog? *

What is heartworm and how is it prevented?*

How often should your dog be checked for internal parasites?*

How often should your dog have booster vaccinations?*

Current (or past) veterinarian's name (If you don't have a current vet, please list who you plan to use for your future pet).*

First NameLast Name

Name of Vet Practice*

Vet's address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Vet's phone number*

Please enter a valid phone number.

Vet's Email*

example@example.com

References
Please list three people who have known you for at least 2 years AND have seen you interact with dogs/animals in some fashion.

We recommend your dog trainer, neighbor, personal friend, co-worker. Please use their most accessible phone number and alert them that we will be calling.

**PLEASE DO NOT USE FAMILY MEMBERS AS REFERENCES**

Failure to meet the above qualifications will result in a delay of your application as we will need to request new ones in order to proceed.

Reference #1 Name *

First NameLast Name

Reference #1 relationship to you*

Reference #1 Home or Cell Phone*

Please enter a valid phone number.

Reference #1 Email*

example@example.com

Reference #2 Name*

First NameLast Name

Reference #2 relationship to you (cannot be a family member. We suggest a dog trainer, neighbor, friend or coworker)*

Reference #2 Phone Number*

Please enter a valid phone number.

Reference # 2 Email*

example@example.com

Reference #3 Name*

First NameLast Name

Reference #3 relationship to you*

Reference #3 Phone Number*

Please enter a valid phone number.

Reference #3 Email*

example@example.com

Have you ever adopted a dog from us before? If yes, let dog's name and year adopted. *

You are aware that if you adopt a dog from MWBCR, you are required to return the dog to us if you can no longer keep it.*

Yes

You affirm that all the above information is true and correct. You understand that the submission of this application does not necessarily mean that you will be approved. We reserve the right to reject any applicant.*

Yes

You understand there is a $20 NON-REFUNDABLE application fee upon submission of this application to continue the adoption process.*

Yes

You have read and understand MWBCR adoption process. You will allow a Home Visit if requested. You understand that all family members (human and canine) who will be adopting/living with the new dog need to travel to the foster home to meet the dog.*

Yes

Date*

Date

My Products

Adoption Application Fee

$20.00 Quantity

Total

$0.00

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