Name: Type: (dog,cat,etc.)Age: Current on Vaccinations?
Are your animals on heartworm prevention?
Type:
Your Veterinarian:
Vet Name:
Clinic Name:
City / State / Zip:
Phone:
If applicable, approximate date of your current pet's last office visit?
Are you willing to pay for a heartworm test (about $20)?
Have you ever had to give a dog up?
If yes, what was the circumstance?
If you have owned other dogs and do not now, what happened to them?
Your Preferences:
Is there a dog on our web page that you are interested in?
If yes, which one?
What sex do you prefer?
Age range?
What kind of Border Collie personality are you looking for?
Care of your Border Collie:
How much per month have you budgeted for taking care of your Border Collie?
How often should a healthy dog go to the vet?
How much do you estimate a typical vet bill to be?
Which brand of dog food will you feed your Border Collie?
Why did you choose this type of food?
Living With Your Border Collie:
Have you ever owned a Border Collie?
If yes, tell us about your Border Collies
Why do you want a Border Collie?
What are your favorite qualities in the Border Collie breed?
What are your least favorite qualities in the Border Collie breed?
Check any of the following you feel are valid reasons for giving away a pet:
What are you expecting from your rescued Border Collie?
Did you read the Adoption Information on our web site?
Training Your Border Collie:
Which of the following methods/tools do you/would you use in training a dog (check all that apply):
Will you take your dog to obedience class?
Briefly describe the methods you will use to discipline your dog when he/she misbehaves (jumping up on you)?
How will you ensure that the Border Collie you adopt accepts you as the alpha figure (for example if it growls at you)?
How will you socialize the Border Collie you adopt?
Are you interested in learning other training or discipline methods?
What activities do you plan to do with your Border Collie?
If you are looking for a herding dog, how will you train it?
If you are sending it to a trainer, please list who the trainer is and their experience:
Would you be willing to send it to a trainer recommended by NBCR?
What books on dog behavior/training have you read?
Please rate your experience with the Border Collie breed:
How did you hear about the Nebraska Border Collie Rescue Group?
List any Humane Societies, Organizations, Breed or Training Clubs you are associated with:
Are you willing to work with us on correcting these problems?
We will attempt to provide you with an honest evaluation of temperament on any dog we have to place.
Adoption Application
Nebraska Border Collie Rescue, Inc.
824 Calais St.
Bellevue, NE 68123
Thank you for your interest in adopting a Border Collie. If you have any questions regarding this application you may e-mail Karen at karenbattreall@cox.net
I understand there will be a $250 adoption fee for puppies through 5 months of age; a $180 adoption fee for dogs 6 months through 6 years; a $120 adoption fee for dogs 7 years and older.
SECTION 1 - Personal Information
Your Name:
Co-Applicant Name:
Street Address:
Apt.or Box:
City / State / Zip:
Daytime Phone:
Email Address:
Cell Phone:
Co-Applicant Cell Phone:
Number of Children:
Age:
Age:
Ages and Names of Children:
1.
2.
3.
4.
5..
6.
SECTION 2 - Employment Information
Applicant:Co-Applicant:
Employer Name:
Employer Address:
Employer City / State / Zip:
Employer Phone:
SECTION 3 - Residence Information
Please mark which of the following best describes your current living situation:
Ownership: Type: Location:
If you Rent or Lease, list the name, address, phone number of your Landlord or Property Owner, who holds your lease/rental agreement:
Landlord / Property Owner:
Address:
City / State / Zip:
Phone:
How long have you lived at this address?
If less than 2 years, please list your previous address:
Address:
City / State / Zip:
Besides your immediate family, are there others residing in your house?
If yes, relationship and name:
Does your home have a yard?
If yes, is it fenced?
What type of fence?
How tall is the fence?
Will the gate be locked with a padlock?
Do you have a swimming pool or a spa?
SECTION 4 - Placement Information
Is someone home during the day?
If no, where will the dog stay while you are gone?
Where will your dog be kept most of the time?
If kept outside, will you have a dog run and/or dog house?
Specify:
Would you let the dog outside by itself occasionally if you had a house with lots of land and away from busy streets?
SECTION 5 - Other Pet Information
SECTION 6 - You and Your Border Collie
Do you realize that often times the complete history of a Border Collie may not be known and you may encounter some behavioral problems?
SECTION 7 - References - ONLY ONE FAMILY MEMBER MAY BE LISTED
Listing more than one family member will delay your application process.
Please include address, phone number and how long known: Name: Address / City / State / Zip:Phone Number:Years Known Relationship to you:
SECTION 8 - Additional Comments
SECTION 9 - Terms and Conditions
I certify that the information provided on this form is true and correct, to the best of my knowledge. I am also financially and physically able to care for this animal. I understand that proper food and veterinary care can be costly and I am able and willing to meet these requirements. Home checks are made on a random basis following or prior to adoption. If upon inspection we find that the information contained in this application to be false, we retain the right to deny your application and/or remove the animal from your premises without a refund of monies paid.
Date:
Signature:
By checking this box and/or signing this form you acknowledge the above statement and agree to accept all terms and conditions herein. A signed application form must be received before your application can be considered.
This application may be submitted over the internet or downloaded and mailed to Nebraska Border Collie Rescue.
Also, please fill out the Release of Personal Information form (see below) and give to your Vet Clinic as soon as possible for completion of your application.
Do you understand a home visit is required before adoption can be completed?
