Online Adoption Application

Thank you for your interest in adopting a BRBCR rescue dog! Our approval process starts with you filling out our Adoption Application. Please take the time to answer all questions thoroughly. A foster parent will be in touch with you soon.

Your Name: *

First

Last

Your Age *

• Under 21
• 21 - 30
• 31 - 50
• 51 - 70
• Over 70

Street Address *

City *

State *

Zip Code *

Phone *

Email Address *

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PLEASE PROVIDE INFORMATION TO HELP US FIND A DOG FOR YOU

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

Have you researched the Border Collie breed? *

• Yes
• No

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

What previous experience have you had with Border Collies? *

What is your ideal time frame for adopting? *

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

• Companion
• Active Pet
• Sport Competitor
• Working Dog

Check all that apply.

Do you have an age preference? *

• Puppy
• Young Adult
• Adult
• Senior
• No Preference

Do you have a preference of gender? *

• No Preference
• Male
• Female

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

Describe in as much detail as possible the daily routine you plan for your dog.

Morning: *

Afternoon: *

Evening: *

Where will dog be kept during the day? *

How many hours will your dog be alone during the day? *

If your dog will be alone for more than 4 hours, what are your plans for taking care of the dog’s needs? *

Where will your dog be kept at night? *

Who will be responsible for caring for your dog? *

How will your dog be cared for during extended absences? *

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PLEASE PROVIDE INFORMATION ABOUT YOUR HOUSEHOLD

Select the following that best describes your location: *

• Urban
• Suburban
• Rural

Select the following that best describes your type of home: *

• Townhouse/Condo/Duplex
• Single family home
• Home with acreage

Select the following that best describes your yard: *

• Fenced yard
• Yard, no fence
• No yard

Do You Rent or Own? *

• Rent (approval from landlord must be provided)
• Own

Describe your yard (include size, type of fencing and height of fencing): *

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?

• Yes
• No

If YES, then Who

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HISTORY & REFERENCES

Pet History

List the pets you currently own or have owned in the past by Name Type Breed Gender Age Status

Pet Name

Pet Type/Breed/Gender

Example: Dog / Border Collie / Male

Pet Age

Pet StatusPet StatusCurrentPast

Veterinarian Info

Veterinarian Name *

Veterinarian Phone *

References

Please list 3 references of people not living with or related to you. BRBCR will not call your references before speaking with you first.

Reference 1 - Full Name *

Reference 1 - Phone *

Reference 1 - Your Relationship *

Reference 2 - Full Name *

Reference 2 - Phone *

Reference 2 - Your Relationship *

Reference 3 - Full Name *

Reference 3 - Phone *

Reference 3 - Your Relationship *

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

• No
• Yes

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

• No
• Yes

If YES, please explain: *

How did you hear about Blue Ridge Border Collie Rescue?

• PetFinder
• BRBCR member
• Web search
• Other rescue
• Other

Who is the BRBCR member that referred you?

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 *

Signature of Applicant: *

Clear Signature

Use your mouse or cursor to sign this document.

BRBCR is completely staffed 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

Submit My Adoption Application