Mo-Kan Border Collie Rescue
c/o Jennifer Fitzwater
3525 N Wabash Ave
Kansas City, MO 64116
(816) 413-7623

Adoption Application (Please read the following before filling out the application)

The Border Collies in our care have been spayed/neutered, tested for heartworms and are heartworm preventative (if older than 6 months), are up to date on vaccinations, and have been taught basic obedience commands. Mo-Kan Border Collie Rescue is composed of volunteers who give their time, energy and open their homes to unwanted and abandoned border collies in order to find them loving and safe permanent homes. Keep in mind that the adoption process normally takes at least 2 weeks to complete. Also keep in mind that the dog that you may be interested in might already have an application pending or may not be the right dog for you. We are very careful to match the appropriate dog with the appropriate family. We feel that is a very important part of the process in insuring our dogs find their permanent homes. The adoption donation of $175 is used to cover the costs of caring for the rescued dogs and includes things such as medical expenses and shelter adoption fees. All potential adopters are required to complete our adoption application as part of the adoption process.

NAME:

ADDRESS:

CITY:

STATE: ZIP CODE:

PHONE:

EMAIL:

How did you hear about MO / KAN Border Collie Rescue?

Do you RENT or OWN your home? Please indicate the type of residence (e.g., rent apartment townhouse; own home, condo, trailer, etc.) If renting, do you have the landlord’s permission to get a dog?

Is your home SUBURBAN, URBAN, RURAL?

Do you have a fenced yard? If not, please indicate how you will exercise the dog in a safe and controlled manner. Type of fencing (height, wood, chain link, etc.) and size of fenced area:

Please list the names and ages of family members living in your household:

Does everyone in the household want a dog?

Is anyone in the household allergic to pets?

Please list other pets in the household along with ages:

What are your family’s daily hobbies and activities?

Please indicate daily work or school hours of all individuals and indicate if anyone is at home during the day.

Where will the dog be during work hours and when no one is home?

Do you intend to keep this dog primarily INDOORS or OUTDOORS? What shelter will be provided for the dog if/when outdoors?

Who will be responsible for the care of the dog?

What happened to your last dog?

In your opinion, what are legitimate reasons for getting rid of a dog?

Have you ever had to get rid of a dog? If yes, why and what did you do?

Why do you want a border collie? .

Have you ever owned a border collie?

Please give a brief description of the type of dog you are looking for (e.g., sex, color, pure or mix, age, activities such as ball, frisbee, herding, etc.)

Have you ever completed obedience training and / or crate training with a dog?

Are you willing to allow a rescuer to complete a home visit by appointment?

Please list name, address and phone number of two references we can contact:

Please list your veterinarian’s name, address and phone number (we will contact the clinic for references):

Please list any other information you would like to add in order to help us match the right dog with your family. Attach a separate sheet if you need more space.

I attest to the truthfulness of my answers. I understand that falsification of any of the above information is grounds to disallow the adoption of a border collie from Mo-Kan Border Collie Rescue.

Signature: ___________________________________ Date: ______________
(Mo-Kan Border Collie Rescue reserves the right to refuse any applicant.)

Please mail the application to the address at the top of the application.

__________________(For Mo-Kan BCR use only)________________________

Vet:

Ref:

HV:

Copyright © 2003 Mo-Kan Border Collie Rescue, All Rights Reserved.

Site Map