Personal Information:

Applicant's Name:

Spouse’s full name:

Address:

City: , State: Zip Code: Home Phone (ex: 123-456-7890):

Work Phone (ex:123-456-7890): | Cell Phone (ex:123-456-7890):
Best time to Call and preferred number:

E-mail address :
(Please check your E-mail frequently for notes from us about your application)

Occupation:

Spouse's Occupation:

Personal References:

Please list three (3) people who have known you for at least for 2 years. We recommend dog trainer, neighbor, personal friend, co-worker. Please list no more than one family member.

Personal Reference #1:
Personal Reference #1 Phone (ex: 123-456-7890):
Relationship to you: E-mail:


Personal Reference #2:
Personal Reference #2 Phone (ex: 123-456-7890):
Relationship to you: E-mail:


Personal Reference #3:
Personal Reference #3 Phone (ex: 123-456-7890):
Relationship to you: E-mail:

Veterinary Reference:

Veterinarian where your pet(s) records are:
Veterinarian Phone Number (ex: 123-456-7890):
Address:
If you don't currently use a vet, please provide previous vet's name:
Previous Vet's Phone Number:

Household Information:

It is our goal to place as many healthy, temperamentally sound animals in homes where they will receive excellent, stable, LIFELONG care. Please read and answer the following:

Do you live in a: House Apartment Condo Mobile Home
What type of area do you live in? City Suburb Rural
Are there any ordinances limiting the number of dogs you can have on your property: Yes No
If yes, how many:
Is your home : Owned Rented

If renting, do you have landlord’s permission to keep a dog inside the home? Yes No
If you rent, you MUST supply your Landlord's information below (if you own your home, enter NONE in the Landlord Name and Phone Number fields below or your application will not go through):

Landlord's Name:
Landlord's Phone Number (ex: 123-456-7890):
Landlord’s Address:
How long have you lived at this address? Years Months
Does your rental agreement have a size limit on a dog? Yes No
If yes how many lbs? lbs.

Current Household Residents:
Please list the number of adults, number of children and ages of children in household:

Number of adults:
Number of children:
Ages of Children in household:
Does anyone in your family have pet allergies?

Care of Pet(s):

Would your dog be living with or encounter any of these situations/activities regularly?
Other dogs cats livestock children under 10
teens joggers bicycles traffic

Which member(s) of the family will be responsible for caring for your new pet (eg., agility, obedience, companion only, nothing)?

What activities or job are you planning with your new dog?
If none, please explain:
Have you ever participated in an obedience class? Yes No
Do you plan to enroll the new dog in an obedience class? Yes No

What form of discipline will you use on your dog?

Will you be crating your new dog? Yes No

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, it may take your dog two weeks to adjust to its new home. What concerns do you have about this adjustment period?


Is there a circumstance that would cause you to give up your dog?

Are your current dogs given vaccinations, heartworm testing and preventative as well as regular check-ups (to include testing for parasites)? If so, how often?

Have you heard of collie sensivity to ivermectin? Yes No
How much do you expect to spend each year on veterinary care?
What kind of food do you currently feed or would you feed?
How much do you expect to spend each month on food, grooming, etc?


Do you have a fenced yard and/or an outdoor kennel run?

Height and type of fence and/or kennel run?
If you do not have a fence or kennel run, how will you let the dog out safely to be exercised and relieve itself?

Where will you keep your dog when left alone?

Where will your dog sleep?

Including commuting time, how many hours per day will the dog be alone?:

If approved for adoption, will your new pet primarily be kept indoors or outdoors?

Current and Past Animals in Houshold:
Please list all pets in the household that you currently own as an adult. Please be specific with type/breed, name, age, is the pet altered (S/N) and how long have you had this pet)


Please list all pets in the household that you owned previously as an adult. Please be specific with type/breed, name, age, was the pet altered (S/N), how long did you have pet, what happened to pet (be specific, ie. hit by car, still have, ect.)

Do you breed animals: Yes No

Please Explain:

Animal Applying For (Please include the name of the available dog you are interested in or provide a description of what you are looking for in your next family member) (If not an animal named on website, please be specific in breed, size, age of animal you are looking for, etc):

Describe your ideal dog (please list gender, age, activity level, etc.):
Have you ever owned a Border Collie or Australian Shepherd before? If not, what previous experience, if any, have you had with these breeds?
Why did you choose this breed?
Are you interested in a particular dog and why?

Researching the Breeds:
In your research of the Border Collie and/or Australian Shepherd, is there anything about the breed that might be an issue for you? Please check all that apply (you may choose more than one):
Dominance Stubborn Destructive chewing Escaping/Run away Jumping on People
Digging Aggression Barking Nervous or Shy Too energetic Biting Submissive
Protective Not good with other pets Rough with children Submissive peeing Nipping at heels
Not getting enough exercise Herding other dogs, cats, children

Would you be willing to allow someone to visit your home by appointment? Yes No

Are you applying at other rescues? Which?

Where did you hear about North Star Border Collie Rescue?


Any additional information you would like us to know about you and your family?

All of the above information I have given is true and complete. This dog will reside in my home as a pet. I will provide it with adequate food, water, shelter, training, affection, and medical care. I understand that North Star Border Collie Rescue is a referral service and is not responsible for the accuracy of information received about the habits, temperament, or physical condition of dogs available for adoption. I understand that it is my responsibility to evaluate the dog for myself before agreeing to adopt it. I am in full agreement with these terms of adoption. North Star Border Collie Rescue shall not be liable for, and is hereby relieved from, all liability for any damage, expenses, causes of action, fines, suits, demands, judgments or claims of any nature whatsoever arising from or by reason of any damage to property or injury to any persons caused in whole or in part by the dog placed in your home. I hereby accept and assume such liability and agree to protect, indemnify and hold North Star Border Collie Rescue harmless from and against all of the aforesaid. Submitting this form constitutes your permission for us to check references. Although every effort is made to give every application fair and impartial treatment when processing all applications, I understand that submission of this application does not necessarily mean that I will be approved to adopt and that North Start Border Collie Rescue reserve the right to reject any applicant for any reason.

WE RESERVE THE RIGHT, IN OUR SOLE DISCRETION, TO REFUSE ANY APPLICANT FOR ANY REASON WHATSOEVER.
Yes | No I have read the disclaimer and agree to these terms and conditions.
Yes No | I am aware that if I adopt a dog from North Star Border Collie Rescue, I am required to return the dog to North Star if I can no longer keep it:

Without your electronic signature, we cannot process your application. Your electronic signature will be evidence of your acceptance of the terms and conditions set forth in this application.

Signature:

PLEASE CONTACT YOUR VET AND LET THEM KNOW WE WILL BE CALLING. WITHOUT YOUR CONSENT, YOUR VET MAY NOT RELEASE INFORMATION TO US.

If you have any questions, please email: northstar@pentel.net

Thank you for applying to adopt one of our dogs. You should be hearing from us shortly.

Please understand that we want the dogs and puppies in our care to go to the best of homes. We want these to be forever homes for them. We reserve the right to deny adoption of a particular dog if we feel that particular pet is not suited to your family, but will suggest another dog we feel would be more suited to your situation. You are under no obligation to adopt the dog of our choosing, but we will make suggestions and denials that are in the best interest of both the adopter and the dog/puppy in question. We hope you understand that we love these pups/dogs and want only the right placement for them. Thank you for your understanding and cooperation.

All dogs are available for adoption on a first come first serve basis to APPROVED ADOPTERS ONLY. We can not hold dogs for anyone, regardless of the pet you are applying for, nor do we have the resources to keep every potential adopter informed as to whether or not the dog(s) they are applying for have been adopted. We are solely run by volunteers who donate their time to help screen applicants and who are familiar with the dogs available for adoption. It is the duty of every applicant to be open to the adoption process and to accept that every dog may potentially be adopted by another approved family prior to your visit--no adopter is guaranteed that the specific dog they are applying for will be available at the time of adoption. When a potential adopter is granted approval to adopt, it does not mean they wil necessarily receive the specific dog they are applying for, only that they are approved to adopt a dog that fits within their family, should one be available. Each dog being adopted must fit within the criteria required for them to be a match in the home they are going to. It is our duty, to the best of our ability, to make sure that each dog goes to its forever home, which means the dog and the family must compliment each other.

North Star Border Collie Rescue is a privately run non-profit organization who fosters their dogs in private residences. Visitation is by invitation ONLY to APPROVED ADOPTERS ONLY!