Personal & Property Details

Full Name & Surname

ID or passport number

Mobile Number

Home Telephone Number

Address

Do you own or rent your dwelling?

Own Rent

How long have you lived at your current address?

Are you planning to move soon? (next 12 months)

Yes No

If you live in a security complex, are dogs permitted and if yes, are there any regulations on the number and size of the dogs you're permitted to keep?

Is there a pool? If yes, is it covered or enclosed? If yes, please advise the type of cover or enclosure.

Is your property fully enclosed? Please provide type and height of fencing.

Are you aware of any dogs being stolen or poisoned in your area before?

Yes No

Do you have children? If yes, state the age(s)

General

What is the reason for selecting this particular breed of dog?

Have you previously owned a Border Collie?

Yes No

What gender do you prefer?

Male Female Either

What age bracket are you looking for?

Have you ever applied to Border Collie Rescue, the SPCA, the AACL, or another shelter for the adoption of a dog? If yes, what was the outcome?

Current Pets

Do you have any other pets?

Dogs Cats None Others

Please specify each of the following for each pet in your household: (a) Breed (b) Sex (c) Age (d) Sterilised or intact (e) Last vaccination date

Are any of your pets kept separate? If yes, why?

If you owned pet/s in the past but no longer have it/them what happened to those pets?

Have you ever had to put a dog to sleep? What was the reason

Do you breed with any of your pets? If yes, which breed organisation are you registered with?

Border Collie Environment

Where will the adopted Border Collie sleep? Indoor or Outdoor? Please specify

How many hours will the adopted Border Collie be alone during the day?

How many hours will the adopted Border Collie be alone during the night?

Where will your dog be during the day (inside or outside)?

Inside Outside

Will your adopted Border Collie have access to your house during the day?

Yes No

Please specify the garden space available to your pets (square meters or length and width of garden space in meters)

Border Collie Care

What will you feed your dog and how often will it be fed?

If you have other dogs, will you be prepared to feed them separately?

yes no

What will you use for tick and flea control?

Are you aware of the approximate costs of feeding a dog? Annual inoculations and supplying tick and flea control and veterinary care?

Yes, I am aware No, I am not aware

When you go away for an extended period, who will take care of your pets?

Who is your vet? (Please input contact details)

What will you do to stimulate and exercise your Border Collie and how often?

Acknowledgement

Terms and Agreement

During any dog’s stay with us we have endeavored to give him not just food and shelter, but also the love and affection every dog craves. This compassion cannot and must not stop when he goes to a new home.

You as a responsible dog owner will understand why we need home checks and other information before your application can be accepted and why we have certain conditions when a dog is adopted by you. Our aim and duty is to ensure any adopted dog receives a good home with responsible loving care.

For this reason we ask you to please read these declarations carefully and make sure that you understand them and your obligations when adopting and owning a Border Collie before you sign the completed form.

By submitting this form, I acknowledge that I have read the following points and commit to following them.

I undertake that:

I am over 18 years of age and can afford the services of a private veterinary practitioner, and will ensure that vaccinations are kept up to date and in the case of illness or injury will take the dog to the vet for treatment without delay.
The adopted Border Collie will have a sleeping area raised off the ground with protection from the wind and rain and that there is adequate shade during the hot summer months.
I will allow the adopted Border Collie to sleep indoors at night.
I will not willingly allow the adopted Border Collie to roam the streets or run free at night and that I will fit a leather or strong webbing collar with a suitable identification tag.
I am prepared to pay the non-refundable adoption fee (see website for details).
I will contact Border Collie Rescue, Cape Town if I have found a dog at another shelter or am no longer interested in adopting one, so they can remove my application.
The completion of this form and/or the checking of my property does not guarantee me a dog from Border Collie Rescue.
I have researched the breed-specific requirements and understand Border Collies need a huge amount of stimulation, exercise and attention and that many Border Collies are extremely afraid of fireworks and other loud noises.

EVERY BORDER COLLIE LEAVING BORDER COLLIE RESCUE IS STERILISED, INNOCULATED, DEWORMED AND MICRO-CHIPPED BEFORE GOING TO THEIR NEW LOVING FOREVER HOME.

Do you Accept these Terms & Declare that the information you have provided is acurate & true

Yes No

Date submitted

Adopt Spike

Spike

Male DOB unknown (we estimate 6 years old)

Border Collie Rescue Adoption Form

Personal & Property Details

General

Current Pets

Border Collie Environment

Border Collie Care

Acknowledgement

Terms and Agreement

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