Today’s Date:

Name of the Collie you

are interested in:

Name(s):

Email:

Address:

Home Phone:

City, Province:

Cell Phone:

Postal Code:

Work Phone:

How many people live at this residence?

What are the ages of everyone who lives here:

Do any children live or spend time here?

If yes, have they been around large dogs before

Does everyone in the home want to adopt a Collie?

Yes    No

Does anyone in the home have any allergies?

Do all the adults work outside the home?

Yes    No

How many hours each day will the Collie be alone?

Has anyone in the home ever adopted an animal before:

Yes    No

If yes, from what group/shelter:

Has anyone in the home ever been denied an adoption?

Yes    No

If yes, please explain why

What is the general activity level like inside the home?

What is the general activity level like outdoors?

What does your family like to do in their spare time?

Has anyone at this residence ever been charged or convicted of animal cruelty or neglect under any municipal, provincial/state or federal law or regulation?

Yes    No

If yes, provide details:

Is your residence a:

         House Apartment Townhome Military Housing Mobile Home Other

Do you own or rent your residence?

       Own Rent

If you rent, will your landlord allow dogs

at this residence?

     Yes No Unknown

Landlord’s name and phone number:

Is this property:

      Rural Working farm Hobby farm Urban Suburban

Do you have somewhere to exercise a dog?

Is your yard fully fenced?

Yes No

If not, how will you contain the dog?

Do you currently have any dogs?

Yes    No

If yes, how many?

Are your current dogs spayed/neutered?

Yes    No

Are your current dogs vaccinated?

Yes    No

What breed(s) do you currently live with:

Are your current dogs good with other dogs?

Yes    No

Do you currently have any cats?

Yes    No

If yes, are they good with other animals?

Yes    No

Have any of your current animals ever bitten a person or another animal?

Yes    No

If yes, please give details:

Please describe your current pets:

Name and phone number of your veterinarian:

*please let your vet know CRN will be calling them*

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 to adopt:

Smooth Rough No Preference

Colour you would

prefer to adopt:

          Sable Tri Blue Merle White No Preference

If a Collie that is not exactly what you are looking for in regards to age, coat type or colour or age is not available, would you consider another Collie

Yes    No

Quiet indoors

Quiet outdoors

Housetrained

Crate trained

Has basic obedience

Likes car rides

Good with kids

Good with dogs

Good with cats

Barks to alert

Good off-leash

Ok w/strangers

Active/bouncy

Calm/laid-back

Couch-potato

Playful

What behaviour(s) would you find totally unacceptable:

Why are you interested in adopting a Collie?

Do you have any experience with Collies or with any other herding breeds?

If not, have you researched the Collie breed and understand they are a herding dog and also that Collies, like any breed are prone to certain health issues?

Do you understand, or have experience with, the fact that Collies are known to be “barkier” than some other breeds and that Collies will “bark to alert” to anything from people approaching the house to leaves blowing around in their yard?

Collies, even Smooth Collies, shed.  Are you prepared, willing and able to brush your Collie on a regular basis and take him to be groomed as required (or groom him yourself)?

If the Collie you are interested in adopting would benefit from obedience classes and CRN recommends this be a condition of adoption, are you willing to enroll in classes with your rescue Collie?

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 minimum donation of $350.00 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 your ability?

Yes, I agree

No, I do not agree