A Non-Profit 501(c)(3) Organization

Serving Northern California
and Surrounding Areas
* NorCal Collie Rescue is California non-profit public benefit 501(c)(3) corporation C2798651 EIN 20-3381549.
   Your donations are fully tax deductible.
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Website to the Rescue


Adoption Application

Pet ownership is a serious responsibility.  The policy of NorCal Collie Rescue is to insure that each person who adopts a dog is aware of that responsibility and willing and able to accept that responsibility.  A collie might not be the best choice of pet for everyone.

The following questionnaire has been designed to aid both you and us in determining if you (and your family) what kind of collie, if any, is the right choice for you.

Please complete the application in detail.  All fields are required.

Ifr this online application does not work for you, please Click HERE to download our Adoption Application in WORD format, complete and send in as per instructed on the document.
PERSONAL AND HOUSEHOLD INFORMATION  
Date of Application
   
Are you applying for a specific dog?  If so, what is it's name?
   
Name
Address
City, State, Zip
Email Address
Daytime Phone
Evening Phone
Best time to call
May we call you at work?
   
Who lives in your home?
What are the ages of each person in your home?
What are the ages of frequent visitors, if they are minors, and how often?
How long have you lived at your current residence?
Are you planning a move in the foreseeable future?
If you were to move, would you insist on a new house having a fenced yard?
If you were to move, what would happen to your adopted dog?
   
Do you own or rent?
What type of home do you live in?
If Other, please explain:
If you rent:
Do you have permission from your landlord, property owner, and/or other household members to adopt?
May we contact the Landlord/Property Owner?
Name & phone number of the Landlord/Property Owner: Name:

Phone:

Does you home have any steps and/or stairs?
If Yes, please explain/describe:
What is the speed limit of the road you live on?
Please define your household:

(Check all that applies)

 

My household is:

Busy (visits by friends, children, parties)

Noisy (TV, Stereo, machinery, tools, children playing)

Moderate (normal comings and goings)

Quiet ("homebodies", few guests, stay home a lot)

Lots of children in the neighborhood

Live on a busy street or highway

   


 
PET OWNERSHIP INFORMATION 
Have you ever owned a Collie?
Would barking be an issue in the area surrounding your home?
Are you aware that a Collie is a double-coated breed that will shed?
Are you willing to provide the necessary grooming and coat maintenance that a collie requires?
Our dogs must be allowed inside with their family, but on the occasion they are left outdoors temporarily, what kind of shelter will be provided?
Do you have a fenced yard?
If Yes, what type of fence?
Does your yard share fence with neighbors who have dog/s?
If so what breeds?
Are they barkers?
Are they outside only dogs?
If Yes, how high is your fence (at the lowest point)?
If Yes, does a door from the house open directly into the fenced yard?
How will your dog access the area for relieving himself/herself?
Are they any pools, jacuzzis or ponds on your property?
If Yes, please explain/describe:
If Yes, is it child fenced or have a child proof pool cover?
If Yes, please describe fence/cover:
If you do have a pool, we require it be child safety fenced, or a child proof cover.
Are you willing to make your pool safe before you adopt a collie?
Where will your dog sleep at night?
Are dogs allowed on your furniture?
Where will your Collie be when you are not home?
(please be specific: ie. dog run, fenced yard, crated, free run of house etc.)
Where will your Collie be when someone is home?
(please be specific ie: with me, dog run, fenced yard, crated, free run of house etc.)
What activity level are you interested in with your new collie?
Active, Medium, Couch Potato
How many hours a day will your dog be left alone?
How will you allow your dog to run and get exercise?
What brand and type of dog food do you plan on feeding your new Collie?
If you do not know, will you feed dog foods recommended by NCR?
Have you previously owned a dog and if so what happened to the dog?
Do you currently own any pets?
If yes, please provide us with the following information:  
Type
(dog, cat, etc)
Breed Size Sex Age Altered Vaccinated? Heartworm
Prevention?
Flea
Prevention?
Do you currently have a Veterinarian?
If Yes, please provide his/her name and phone number:
May we contact him/her for a reference?
Do you have the time and/or patience to train a dog if it not already trained?
Will you take your new dog to obedience class if we recommend it?
Do you have experience training your past dogs?
If so, please be specific ie: self, private trainer, group classes,
Type of training
What behaviors, if any, would cause you to give up your dog?
How often do/did your dogs get groomed?
Are you willing to crate your adopted dog when traveling in a car or provide a car harness?
Dogs are fostered all over Northern California.  Are you willing to travel to meet and transport the dog to your home?
AKC reports it costs over $1,000 or more per year to properly care for a dog, which includes, but not limited to:  vet care, medications, food, licensing, shots, grooming, etc.
Are you aware of this financial responsibility of dog ownership?
Can you afford the financial responsibility of dog ownership?
If you are employed, do you work from home or away?
How far is your commute to work?
If you are unable to care for your collie, do you understand that they must be returned to NorCal Collie Rescue?
What is the primary reason you want a Collie?
Will you agree to a "home check" by a NCR volunteer?
   

 
PREFERENCES 
Do you have a color preference?
Do you have a coat preference?
Do you have an age preference?
Do you have a gender preference?
Would you be willing to take a "Special Needs" (shy, handicapped, medication, behavior problem) dog?


MISCELLANEOUS INFORMATION 
Have you submitted an application with any other rescue group?
   
If you have contacted a NCR volunteer already, please tell us who:
   

Any other Comments, Questions, or Concerns?
(Your typing space is unlimited so please feel free to type as much as necessary)





To validate human entry of this application, please type the word DOG in this box: