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ADOPTION APPLICATION FORM

In order for your application to be accepted by Blue Ridge Border Collie Rescue, all fields marked with * are required. Please take the time to answer each question fully. Suggested browsers are Firefox and Safari. If you encounter any issues with submitting this form, please email our Dog Listing Coordinator at brbcrdogs@gmail.com to request assistance.

Please indicate which dog you are interested in (dog's name)*

Your Name*

Your Age*

Your Address*

Primary Phone*

Primary Email Address*

Employer

Position

Work Phone

Why are you interested in adopting a Border Collie as opposed to any other breed?*

What previous experience have you had with Border Collies (if any)? Have you researched the breed?*

What is your ideal time frame for adopting?*

Which of the following best describes the dog you feel would fit in your lifestyle?*

Would you like a male or female?*

Do you live in*

Do you rent or own?*

Do you have a fenced yard?*

Type of fence

Height of fence

Where will dog be kept during the day?*

Where will dog be kept at night?*

How many adults live in your household?*

How many children live in your household?*

Ages of children in household?*

Is there anyone home during the day?*

If YES, then Who?

Who will be responsible for caring for this dog?*

How may hours will this dog be alone during the day?*

What activities do you plan to pursue with your new dog?*

Have you ever re-homed or given up a dog or cat to an animal shelter, SPCA or pound?*

If YES, please explain

Name of your Veterinarian:*

Phone # of your Veterinarian:*

Describe in as much detail as possible the daily routine you plan for your dog. (Morning, Afternoon, Evening)*

Please list the pets you currently own or have owned in the past: Breed, Sex, Age, Current status?

Reference 1 (name of person not living with or related to you)*

Reference 1 Phone#*

Reference 2 (name or person not living with or related to you)*

Reference 2 Phone#*

Reference 3 (name of person not living with or related to you)*

Reference 3 Phone#*

Have you or anyone in your household been convicted of animal cruelty, neglect, or abandonment?*

How did you hear about Blue Ridge Border Collie Rescue?*

If Other, please describe

Use the space provided below to give us any other comments or information you think may help us match you with the right dog for your home

BRBCR is completely operated by volunteers who care about these rescue dogs, and new volunteers are always welcome and needed. If you are interested in finding out more about BRBCR's Volunteer Program, please indicate any areas that interest you. Our Volunteer Coordinator will contact you by email. (This field does not affect your adoption application.)

Would like more information on volunteering in general

Transport of rescue dogs (usually within a 60-mile radius)

Make phone calls to check references of a person who has applied to adopt a dog

Conduct a home visit with people in your area who have applied to adopt a dog

Short-term fostering (less than 7 days)

Fostering (average of 4 weeks)

Help at a booth for an event or fundraiser

Not interested in volunteering at this time

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ADOPTION APPLICATION FORM

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