Adoption Application
Name of the dog you are interested in:
Today's Date
-
Year
-
Month
Day
Date
Your Name:
*
First Name
Last Name
Address:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
-
Area Code
Phone Number
Cell Number
-
Area Code
Phone Number
About Your Family:
How many people live at this residence:
*
What are the ages of everyone who lives here:
*
Do any children live/spend time here:
*
If yes, what are their ages:
Does everyone in the home want to adopt a dog at this time:
*
Does anyone in the house have allergies:
Do all the adults work outside the home:
*
How many hours each day will the dog be alone:
*
Has anyone in the home ever adopted from a rescue/shelter before:
*
If yes, which rescue/shelter:
Has anyone in the home ever been denied an adoption before:
*
If yes, please explain why:
What is the general activity level like in the home (active, loud, quiet, calm, etc.):
*
What is the general activity level like outdoors (gardening, long walks, sports, etc.):
*
Has anyone at this address ever been charged or convicted of animal cruelty or neglect under any municipal, provincial, or federal law or regulation:
*
Yes
No
About Your Home:
Is your home a:
*
House
Apartment
Townhome
Mobile Home
Other
Do you own or rent this residence:
*
Own
Rent
If you rent, please provide the name and phone number of your landlord:
Do you have somewhere to exercise a dog:
*
Yes
No
Is your yard fully fenced:
*
Yes
No
If not, how will you contain the dog:
About Your Current Pets:
Do you currently have any dogs:
*
Yes
No
If yes, how many:
If yes, are they spayed/neutered:
Yes
No
If yes, are they vaccinated:
Yes
No
If yes, what breed(s) are they:
Are they good with other animals:
Do you currently have any cats:
*
Yes
No
Do you have any concerns with the cats meeting/living with a new dog:
Have any of your animals ever bitten or caused injury to a person or to another animal:
*
Yes
No
No animals currently
If yes, please explain:
Describe your current pets (likes, dislikes, where did you get them, etc.):
*
Name of your Veterinarian
*
First Name
Last Name
Clinic Name:
*
Veterinarian/Clinic phone number:
*
-
Area Code
Phone Number
About What You Are Looking For:
Age you would prefer to adopt:
*
Under 1 year
1 - 4 years
5 - 8 years
8+ years
No Preference
Gender you would prefer to adopt:
*
Male
Female
No Preference
Coat type you would prefer:
*
Rough
Smooth
No Preference
Coat colour you would prefer:
*
Sable
Tri
Blue Merle
White
Other
No Preference
If a Collie comes in that matches your home but is not the coat type/colour/age/gender that you prefer, would you consider this Collie for adoption or would you prefer to wait:
*
Would consider
Prefer to Wait
Please check all behaviours/traits that are important to you:
Quiet Indoors
Knows Basic Obedience
Quiet Outdoors
Calm/laid back
Good with cats
Good with other dogs
Good with children
Housetrained
Good off-leash
Crate trained
Active/bouncy
What behaviours/traits would you find totally unacceptable, or would not work in your home:
*
General Information:
Why are you interested in adopting a Collie:
*
Do you have experience with herding breeds:
*
Do you understand that Collie are known to be a bit "barkier" than other breeds and many Collies will "alert bark" to anything from people walking past the house to leaves blowing in the yard:
*
Yes
No
Unsure
Collies, even Smooth Collies, shed. A lot. Are you prepared for the amount of brushing at home that will be required and are you willing and able to take the Collie to be groomed as required (or groom yourself at home if that is an option):
*
Yes
No
Unsure
If the Collie you are interested in would benefit from an obedience class and CRN recommends attending classes as a condition of adoption, will you follow through and enroll/attend obedience classes:
*
Yes
No
Unsure
Additional Information: If you would like to add anything you feel we should know about your family, your home or what you are looking for, or if you would like to expand on any of your answers above (or to clarify any "other" choices above), please us this space:
*IMPORTANT INFORMATION BELOW*
Please read carefully before submitting this application
Do you understand that Collie Rescue Network makes NO warranties as to the temperament, habits, behaviours or health of any Collie you should choose to adopt and all adoptions are based solely on your own judgement?
*
Yes, I understand
No, I do not understand
Do you understand that Collie Rescue Network requires a donation of $500 to help off-set some of the costs incurred by the Collie while in the care of the rescue:
*
Yes, I understand
No, I do not understand
Do you understand that completion of this adoption application is in NO WAY considered approval or acceptance as an adopter and is used only as a tool and that Collie Rescue Network reserves the right to refuse any adoption, for any reason, at any time?
*
Yes, I understand
No, I do not understand
Do you state that the information provided on this application was filled in by the person applying to adopt a dog from Collie Rescue Network and that all information is true and accurate to the best of my ability?
*
Yes, I understand
No, I do not understand
Submit
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