Home   Adoptable Dogs    Adoption Application Courtesy Listings     Our Alumni
Want to Volunteer? Special Thanks   Helpful Reading Booster Club Online Store Donations
Owner Relinquishments Shelter Relinquishments      Site Map Story Corner Contact Us

The Adoption Application

An adoption fee of $225.00 (which includes the $10 application fee) is required
for all dogs and will be payable at the time of adoption.
All dogs are spayed/neutered, vaccinated (includes Rabies, Distemper), microchipped,
heartworm tested and kept on monthly heartworm preventative prior to adoption.

As part of the application and approval process, MBCR will call your veterinarian to check health records on current and past companions. We would encourage you to call your clinic and give them authorization to release this information to our group before filling out the application so that this information can be supplied at this time. This step will help expedite your application.

You will need to have the date you called your clinic and the person you talked to when authorizing the release of information.

All fields are required

About you and your family

The following information will assist us in determining the best dog for your current living/family situation.
Please be honest and answer all the questions. All information will be treated as confidential.
Any incomplete applications will be denied.

Your Full Name 
Your Spouse's Full Name
Street Address
City 
State
Zip Code
Phone
Cell Phone
Email Address 
How often do you check your e-mail? 
Name and ages of all household members:
Are all household members in favor of this adoption?
Please list names, types, ages and genders of all current household pets:
Types and approximate number of livestock (including horses) If no livestock please indicate that.:
 
 
Type of area you live in
Do you rent or own:
 
 
If you rent, do you have written permission from your landlord?
 
Landlord's Name and Phone Number
Approximate size of Yard:
Height and Type of Fencing:
 A call to your Vet will be placed to check on sterilization of your present pets, current vaccinations and monthly Heartworm preventative for any dogs you may own.
Vet's name:
Vet's Phone Number 
Date I called my vet:
Name of the person I spoke to:
If no veterinarian release information is supplied, please explain

MidAmerica Border Collie Rescue requires at least one personal reference.
Space has been provided for 2. All information is required.
Personal Reference #1

Full Name:
Phone Number (including area code):
Relationship to applicant
Personal Reference #2

Full Name:
Phone Number (including area code):
Relationship to applicant
Number of hours you normally spend with your pet daily:
How long have you been looking for a dog?
Have you applied to adopt a Border Collie from another rescue group?
If so, who?
 ABOUT THE DOG YOU ARE LOOKING FOR
Is there a particular dog that you're interested in? Which dog?
If you are interested in one dog, would you consider another if the dog you are interested in got adopted, or the foster felt you were not a good match for that dog?
What kind of dog are you looking for?
What particular traits are important?
What do you consider undesirable traits?
Description of Dog's Living Quarters:
Do you have a gender preference?
Do you have a color preference?
Does your new dog need to be good with children?
Does your new dog need to be good with cats?
On a scale of 1 - 10, 10 being a very active dog, what is the activity level of the dog you are looking for?
Would you consider a special needs dog?
Do you have an age preference? (check all that apply) less than 1 year 1 - 3 years
4 - 7 years        8 and older Doesn't Matter
Would you consider a border collie mix?
My family and I realize Border Collies need to be placed with active people.
Please list any activities you think you might participate in with your new dog. (agility, obedience, herding, walking, etc.)
Please tell us about any previous experience in obedience training:
Have you investigated obedience trainers in your area? (facilities, training methods, previous experience)
Are you willing to enroll your new dog in training?
How soon would you be able to do so?
Are there any circumstances, conditions, behaviors that would force you to relinquish your new dog?
Do you have any previous Border Collie experience:
Have you ever owned a Border Collie or BC mix?
Why are you interested in owning a Border Collie or BC mix?
Describe the ideal BC or BC mix.
Have you ever had to relinquish or surrender a pet in the past (especially a BC)?

If so, please describe the circumstances.

CARE AND TRAINING
Who will provide the majority of care for this pet?
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?
Once your dog arrives, how long do you feel he/she needs for an adjustment period?
Where will the dog be kept during the day? (check all that apply) Crated Inside House Porch Fenced Yard Kennel/Run Garage Tied Outside
 Loose in unfenced area Other
Where will the dog be kept at night? (check all that apply) Crated Inside House Porch Fenced Yard Kennel/Run Garage Tied Outside Loose in unfenced area Other
On average, how many hours a day will your dog spend alone?
If for any reason you are unable to keep this dog, what would you expect to do with it?
Please answer the following questions.
What are Heartworms?
How do you prevent Heartworms?
What brand of preventative are your dogs currently taking?
How often do dogs need vaccinations?
What kind of flea/tick prevention do you use?
Please explain why you picked the dog you are applying for
What Role will this dog play in your life (check all that apply)
Companion for me
 Protection/Watch Dog
 Hunting Dog
 Companion for other Dog
 House Pet

 Sport/performance Dog
For Fun
For Competition

Jogging Buddy
 Gift
 Friend for a child
 Outside Dog
 Working Dog
 Other
Do you have any questions or comments?
How did you find this website?
I/we hereby affirm that all of the above information is true and correct. I/we understand that submission of this application does not necessarily mean that I/we will be approved to adopt and that MBCR reserves the right to reject any applicant. I/we authorize MBCR or any of its authorized agents to verify any and all information set forth in this application and to contact my/our personal references. 

Initials

Date

Without your initials and $10 application fee (payable on the confirmation page which you will be taken to once you click the submit button), we cannot process your application.
 

MidAmerica Border Collie Rescue is a 501(c)(3) non-profit organization