* Name:
* Address:
* City:
*
Province/State:
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
North West Territories
Nova Scotia
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Alaska
Alabama
Arkansas
Arizona
California
Colorado
Connecticut
Washington DC
Delaware
Florida
Georgia
Hawaii
Iowa
Idaho
Illinois
Indiana
Kansas
Kentucky
Louisiana
Massachusetts
Maryland
Maine
Michigan
Minnesota
Missouri
Mississippi
Montana
North Carolina
North Dakota
Nebraska
New Hampshire
New Jersey
New Mexico
Nevada
New York
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Virginia
Vermont
Washington
Wisconsin
West Virginia
Wyoming
* Postal Code/Zip:
Phone:
* Email:
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.
* Have you lived with or personally owned a Border Terrier before?
Yes
No
If the answer to the first question was "No", what made you choose a Border Terrier and what sources of information did you use to learn about the breed?
Are you looking for a Border Terrier that you can work and/or compete with in the following activities (check as many as you like):
Eathdog Tests
Hunting
Obedience
Rally
Therapy
Tracking
Agility
Flyball
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
* Adoption fees vary depending on the age of the dog and the circumstances and may range from $0 to $1000.
Are you willing and able to pay an adoption fee?
Yes
No
* Are you willing to have a CBTW representative visit your home?
Yes
No
* Please list all the adult members of your household with their ages.
* If you have children at home or regularly visit your home please provide their
ages and experience with dogs.
* Please provide information on any other pets you currently own.
* Please provide information on any dogs you have owned in the past and the circumstances under which they left your household.
* How would you describe your accommodation.
House
Apartment/Condominium
* How would you describe your location?
Rural
Urban
Suburban
* Do you have a yard?
Yes
No
* If the answer to the above is "yes", please describe the fencing.
* If no fenced yard, how will you handle your dog's exercise and toilet needs?
* Is it important to you to walk with your dog off leash?
Yes
No
* If you work outside of the home, what is the maximum amount of time the dog would be left alone?
* 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
* What plans do you have for your dog when you go on vacation
Who will be the primary caregiver for your Border Terrier?
Please use the space below if there is anything else you would like to tell us. .