Adoption Application on behalf of NABTW

Please complete the following application. Additionally, mention which dog you are interested in or describe your perfect dog. We want to place the right dog with you! Please make sure to complete the required areas noted so that we may contact you with further information. The application cannot be processed without this information and don't forget to click on "submit" at the end.

If you would prefer an application form that you can print out, complete and mail, please click here

Contact Information

Name:                     * required
Address:                 * required
City:                        * required
Province/State:        * required
Postal Code/Zip:     * required
Phone:                    * required
Email:                     * required
The following questions are not intended to be critical or judgmental. The answers will help us in placing a Border Terrier with you. It may even help us and you to realize that a Border Terrier is not the right breed for you. When we place a dog in a new home we want the placement to be a happy situation for you and your family as well as the dog. We also want the placement to be a permanent placement for the life of the dog (Border Terriers can live 13-18 years). Please answer all of the questions before submitting the form. There are no wrong answers so please answer honestly.

Home Environment

Age:                Occupation:  
Best time to contact:   A.M.  P.M.
How would you describe your location
Rural/Country:   Suburban Neighbourhood:   Urban
How would you describe your residence
House:   Apartment/Condominium
Do you rent or own  
If you rent, do you have permission from your landlord to have a dog? :  
(Please enter the name and phone number for your landlord:  )
Do you have a fenced yard?
Yes   No
If the answer to the above is "Yes", please describe the type of fencing, height and the size of the dog area
If the answer to the above is "No", please describe how will you keep your dog confined and safe?
Please list the members of your human household including frequent visitors, their relationship to you and their ages:
Is anyone in your household including frequent visitors allergic to dogs?
What are your grooming expectations?
What do you know about Border Terriers? What qualities appeal to you? What sources of information did you use to learn about the breed?
Are you aware that Borders do shed and otherwise pose a clean house challenge with muddy footprints, etc?
What kind of temperament would best suit your household?
Who will be the primary caregiver for your Border Terrier?
Hours the dog would be alone daily:
Where would you leave the dog while you were out of the home? (you may select more than one answer):
Free run of the house Confined to part of the house Crate
Other Please specify
Where will the dog sleep:
What plans do you have for your dog when you go on vacation or are away from home
Which, if any, of the following activities would you like to share with your dog? (check as many as you like):
Eathdog Tests Hunting Obedience Rally Therapy Tracking Agility Flyball
What will you do to protect your dog from getting lost?
What dollar amount do you expect to spend to take care of a dog annually?
How will you obedience train the dog?
Is it important to you to walk with your dog off leash?
Yes    No

Dog Preference

Which dog or dogs interest you on our site:
Do you have a strong preference for male or female?
Male    Female    No Preference
If you have a preference, please explain why.
We very rarely get puppies into rescue, mature adults and sometimes seniors are more likely.
Keeping in mind that many Border Terriers remain active into their teens, please indicate what age group you would prefer (you may select more than one age group):
Puppy   Young Adult   Mature Adult   Senior   Dog with special needs (may be health or personality related)
Would you consider adopting a Border Terrier mix?
Yes    No
How far would you be willing to travel to adopt a rescue?

Pet Information, past and present

Have you lived with or personally owned a Border Terrier before?
Yes   No
Do you currently own or live with any other animals?
Yes   No
If yes, what type, spayed/neutered, and age are these animals?
If any of your current animals have medical conditions, please explain:
Who is your current vet? (Name and telephone number)
Who is your current groomer? (Name and telephone number)
What vaccinations do you give your dogs and how often?
What brand of dog food do you feed?
What brand of heartworm preventative do you use?
What brand of flea and tick preventative do you use?
Under what circumstances would you give up a dog?
If you have a one cat/dog household, does your cat/dog get along with other dogs?
Have you ever given up a dog? If you have, please explain why?
Please provide information on any dogs you have owned in the past and the circumstances under which they left your household.
Have you ever adopted a dog from any rescue group before? If yes, please identify breed and rescue group:

References and Additional Information

List a personal reference who does not live with you: Name and telephone number:
Are you willing to have a NABTW representative or delegate visit your home?
Yes    No
Adoption fees vary depending on the age of the dog and the circumstances and may range from $0 to $350.
Are you willing and able to pay an adoption fee?
Yes    No
Please use the space below if there is anything else you would like to tell us or if you have any questions or comments for us: