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Pied Piper Border Collies Adoption Questionnaire
The questions below are meant
to help you and I determine if a Border Collie is the right breed for you,
and to guide you in thinking
about all the ways a dog will impact your life.
The questions address various
aspects of dog ownership that should be given serious
consideration before you decide
to share your life with any dog. Your answers help us assess
your suitability as a home
for one of our BCs, and to match a dog to your particular lifestyle. Please be
as specific as possible, and
answer all questions as completely and truthfully as you can.
It helps us help you!
You and Your Family
Name ____ _______________
Address _____________________________________________
____________________________________________________
Home Phone _________________________________________
Work Phone __________________________________________
Email _______________________________________________
________________________________________________________________________
Preferences,
Please star-sign (Shift-8)
any preferences.
Male
Female No preference
Puppy
Adult No preference
Any other preferences?_________________________________________________
Why a Border Collie?
How did you first learn about
the Border Collie breed?
_______________________________________________________________________
What attracted you to the
__ Border Collie _____________________________________________________________________
How would you describe the
ideal dog for you and your family? (Please be
as specific as possible.)
_____________________________________________
_______________________________________________________________________
What other breeds have you
considered? ________________________________
_______________________________________________________________________
_______________________________________________________________________
Are you familiar with the
temperament and characteristics of Border Collies
in general and Border Collies
in particular?
Yes No
Explain
_________________________________________________________
__________________________________________________________________
Have you previously owned
a Border Collie
? Yes No
If
yes, when did you acquire it? Year ____________________________
Breeder's
name ___________________________________________________
Location
_________________________________________________________
Dog's
Temperament ________________________________________________
If no, have you personally
met a Border Collie ? Yes No
If
yes, please describe __________________________________________
__________________________________________________________________
Pet Ownership
Why do you want a dog? ________________________________________________
_______________________________________________________________________
Do you have any reservations
about dog ownership, the commitment, responsibilities,
the work, and resources required?
Yes No
If
yes, please describe __________________________________________
__________________________________________________________________
Have you ever owned a dog
before? Yes No
If
no, have you ever lived in a household with a dog? Yes No
How
long ago? _________________________
What dog care responsibilities
did you have? __________________________
_______________________________________________________________________
Please list all the dogs or
cats that currently live in your household.
Type/Breed
Sex Altered? Age Years Where do they stay?
______________
___ Yes No ____ ____ ____________________
______________
___ Yes No ____ ____ ____________________
______________
___ Yes No ____ ____ ____________________
______________
___ Yes No ____ ____ ____________________
______________
___ Yes No ____ ____ ____________________
Please list any dog you have
owned in the past and explain what happened to it.
Breed
Sex Altered? Age Years Dates
What happened to it?
______________
___ Yes No ____ ____ ____to_____ ___________________
______________
___ Yes No ____ ____ ____to_____ ___________________
______________
___ Yes No ____ ____ ____to_____ ___________________
______________
___ Yes No ____ ____ ____to_____ ___________________
______________
___ Yes No ____ ____ ____to_____ ___________________
Have any of your dogs had
puppies or fathered a litter? Yes No
If
yes, please describe __________________________________________
__________________________________________________________________
Have you ever had any complaints
from others about your pets? Yes No
If
yes, please describe __________________________________________
__________________________________________________________________
Based on your past dog experience,
is there anything you might do differently with
your next dog? Yes No
If
yes, please describe __________________________________________
__________________________________________________________________
How will you safely introduce
and integrate a Border Collie with your existing pets?
_______________________________________________________________________
_______________________________________________________________________
Your Home
Which of the following best
describes your current residence?
Own a single
family home
Rent/Lease
a single family home
Own a townhouse/condo
Rent/lease
a townhouse/condo/apartment
Other _________________________________________________________
If you rent/lease, is your
landlord agreeable to your owning a dog? Yes No
Does your town or city have
any restrictions on the number of dogs you can have?
Yes
No __________________________________________________
Would any of your neighbours
object to your getting a dog? Yes No
Your Yard
Is your back yard completely
and securely fenced? Yes No
If
not, please explain how you plan to exercise your dog and allow it to
relieve
itself? __________________________________________________
Type: ________________________________________
Height: ________________
Is the fence secure and solid?
Yes No
What type of gates do you
have? _______________________________________
Do all the gates have locks?
Yes No __________________________
Can children open the gates?
Yes No __________________________
Can a dog dig under the fence?
Yes No _______________________
If you have a pool, is it
fenced? Yes No _____________________
If you have a dog run, is
it secure? Yes No __________________
Is it shaded? Yes No ________________
Are there any dangerous articles
in your yard that could harm a dog? Yes No
If
yes, please describe __________________________________________
__________________________________________________________________
What distractions are you
aware of outside your yard that could plague a dog
(such as a neighbour’s dog or cat, loose dogs on street, mischievous children)?
Care & Responsibility
Who will be primarily responsible
for the dog's care and training?
(Children under 11 years can not be expected to look after and train a dog.)
_________________________________________________
Is someone normally at home
most of the day? Yes No
How many days will the dog
be alone in a normal work week? _________ days
How
many hours per day? _________ hours
How much time do you have
to spend with your Border Collie
on a normal workday?
_______________________________________________________________________
On
a normal free day? ____________________________________________
Where will your Border Collie
spend the day?
Loose indoors
Basement
Crate
Garage
Kennel
run
Loose outdoors
in fenced yard
Tied up
outside
Other __________________________________________________________
Will there be some protection
from the elements when outside? Yes No
Where will the dog sleep at
night? (Please be specific.) ______________
_______________________________________________________________________
What routine family activities
will your dog participate in?
_______________________________________________________________________
_______________________________________________________________________
How regularly (daily, weekly,
or monthly) and for how long (miles or minutes)
will the dog be exercised?
____________________________________________
_______________________________________________________________________
Who will be responsible for
exercising the dog? _______________________
Do you travel frequently?
Yes No _____________________________
Who will take care of your
dog while you are away? ____________________
_______________________________________________________________________
Will your dog be professionally
groomed? Yes No
If yes:
Groomers
Name ___________________________________________________
Grooming
Shop ____________________________________________________
Location
_________________________________________________________
Work
Phone _______________________________________________________
If not, who will groom
the dog? _____________________________________
Approximately how often will
the dog be groomed?
Bathing
_____________________________________________
Brushing/comb
out ___________________________________
Trimming
____________________________________________
Do you have the time, and
are you physically able, financially prepared, and
willing to:
--Pay someone
up to $65 or more to groom your Border Collie?
Yes
No __________________________________________________
--Spend approximately
one hour each week brushing and combing out your Border Collie ,
or
more if it gets into foxtails, burrs, or gets wet?
Yes
No __________________________________________________
--Clean inside
the Border Collie‘s ear canals every month to prevent
ear
infections?
Yes
No __________________________________________________
--Clean the eyes
of accumulated matter every single day if necessary?
Yes
No __________________________________________________
--Pay for the
cost of both routine veterinary care (worming, annual shots)
and
non-routine/emergency veterinary care, especially as the dog gets older?
Yes
No __________________________________________________
Do you have a veterinarian
you have used before and plan to use with your next dog?
Yes No If
yes:
Veterinarian's
Name ______________________________________________
Clinic
___________________________________________________________
Location
_________________________________________________________
Work
Phone _______________________________________________________
Do you plan on continuing
the puppy insurance that comes with the dog?
yes/ no / will look into it further.
Behaviour & Training
Would you be willing to participate
in a formal obedience training program with Border Collie Yes No
Have you ever trained one
or more dogs? Yes No If yes:
Type
of training _________________________________________________
When
_____________________________________________________________
Method
___________________________________________________________
Instructor
_______________________________________________________
Are you familiar with crate
training and its dos and don'ts?
Yes
No ____________________________________________________
Are you willing to provide
training to resolve behaviour problems?
Yes
No ____________________________________________________
What amount of time and effort
do you want to devote to training your dog?
_______________________________________________________________________
How would you describe your
attitude about training (firm, tolerant, lenient, etc.)?
_______________________________________________________________________
Have you done any reading
on animal behaviour modification/dog training?
Yes
No If yes, please list the books you have read ________
__________________________________________________________________
What behaviour problems have
you solved through training? ______________
_______________________________________________________________________
Commitment
Border Collie can live
to be 15 years, representing a 15-year commitment to
you. Consider how old you
will be 15 years from now, and how you will feel about this
commitment then.
Are you and those living with
you committed to spending the next 15 years
providing health care, food,
grooming, training, and attention to your Border Collie?
Yes
No ____________________________________________________
Is there a chance that you
might move at least once in the next 15 years?
Yes
No ____________________________________________________
Are you willing to take your
Border Collie with you, and restrict your choice of housing
to places where pets are allowed?
Yes
No ____________________________________________________
Have you carefully considered
how the dog will fit into your current ifestyle,
and how dog ownership will
change your daily routine and schedule?
Yes
No ____________________________________________________
What changes do you expect
in your lifestyle and daily routine when you own a dog?
_______________________________________________________________________
_______________________________________________________________________
Is there a possibility that
your current lifestyle is so busy you might not have
the time or energy to properly
care for a Border Collie? Yes No
Explain
__________________________________________________________
Think about what major changes
might happen in your life in the next 15 years.
Marriage?
Divorce? Children? Job uncertainty? Job transfer? New career? Retirement?
Are you willing to continue
spending the time, energy, and money to care for the
Border Collie as you deal
with these life changes or new responsibilities?
Yes
No
If you're getting a pet for
children you have now,
How old are they now?_____
Children under 11 years can not be expected to look after and train a dog.
How old will they be in 15
years?_____
Are you willing to teach young
or inexperienced children how to respect and
properly handle a live animal?(Young children must never be left alone with any dog)
Yes
No ____________________________________________________
Will you still want the Border
Collie after the kids have grown up and moved out?
Yes
No ____________________________________________________
Does everyone in the family
want a dog? Yes No
References
Please provide three names
as references, including your landlord (if you rent your home), and your veterinarian,
groomer, or dog trainer (if
you have one). If you belong to a dog club or any dog-related group,
include the name of
an officer or associate. Other references could include a neighbour, your employer,
a friend, or relative who
owns a Border Collie , or another high maintenance breed.
Name
Phone Number Relationship
to applicant
_________________________
____________________ ______________________
_________________________
____________________ ______________________
_________________________
____________________ ______________________
_________________________
____________________ ______________________
Thank you for taking the time
to complete this questionnaire.
When you are finished, please
send it kathryn.stevens@rci.com