Belgian Sheepdog Rescue Trust Adoption Application

Thank you for your interest in the Belgian Sheepdog Rescue Trust. The ownership of a Belgian sheepdog, like any pet, is a serious responsibility that requires a long-term commitment. It is the goal of the Belgian Sheepdog Rescue Trust program to be sure that this responsibility, as well as the financial, physical and psychological needs of each Belgian sheepdog be met in its new home. This application has been designed to help potential Belgian sheepdog adopters address the issues that would directly effect their home and its suitability for a Belgian sheepdog. It will also aid the BSDRT in applicant evaluation. Please answer all questions as completely and truthfully as you can. You will not be approved or rejected as a placement solely on the basis of your answers. A phone call from a Belgian Sheepdog Rescue Trust representative will be placed to you to discuss your application in greater detail. . When we think that you are a possible match for a particular dog, we will contact you for a second interview. The content of the second interview will be based on a particular dog. The time between the first general interview about your application and the second, more specific interview can be either a few weeks or a month or more. depending upon the needs of our dogs and whether or not your life style can meet these needs. Profiles of available dogs may be seen at www.BSCARescue.com but we cannot answer calls or emails about a particular dog until an application has been completed. Please read our web site carefully before completing the application and many of your questions will be answered. YOUR APPLICATION WILL BE ACTIVE FOR ONE YEAR. .

Contact the BSCA Rescue Webmaster - Phil Camera if you have any problems or questions.

Applicant Information

Please enter the date:

Please enter your name:

Please enter your email address:

Please enter your address:

Please enter your City, State:

Please enter your Phone:

Please enter your Occupation:

Please enter your Employer:

Number of Adults in Household:

Number of Children and Ages:

Who will be Responsible for the Care and Training?:

Preference of Dog's Age(s) (Check all that apply.)

 2 mos-1 yr 1-3 yr 3-6 yr 6-10 yr 10-17 yr

Preference of Dog's Sex

 Male Female Doesn't Matter

Are you Applying for a Specific Dog?

 Yes No

If so, Which Dog:

Would you consider another dog if that dog is not Available?

 Yes No

Home Information

Type of Home

 Single Family Townhouse/Condo Apartment Other

If you Rent or Lease, please provide Landlord Name, Address & Phone:

Is your yard fenced?

 Yes No

If Yes, please give size of fenced area, type of fence & height:

If No, please explain how and where you will exercise the dog and allow it to relieve itself:

Lifestyle

Is someone home during the day?

 Yes No

If not, how many hours will the dog be alone during the weekday?

Where will the dog spend the day?

 Loose Indoors Basement Crate Garage

Fenced Yard Loose Outdoors Tied Up Outdoors

Kennel Run Other

If Other, please describe:

Where will the dog sleep?

If you travel, who will take care of the dog?

Are you willing to modify your daily schedule to accomodate the dog's needs (exercise, walks, potty needs)?

 Yes No

Are you willing to keep a collar with an ID tag on your dog at all times?

 Yes No

Are you willing to microchip or tattoo your dog?

 Yes No

Pet History

Do you currently own one or more dogs?

 Yes No

Please list the dog(s) names, breed, sex & ages:

How many dogs have you owned in the past 10 years?

Please list them and explain what happened to them:

If you have never owned a dog, please tell us what you expect from owning a Belgian Sheepdog:

What other pets do you have?

Have you ever bred or raised dogs?

 Yes No

Have you ever trained dogs?

 Yes No

Are you familiar with crate training?

 Yes No

Describe the activity level of the household:

 Very Quiet Always Something Going On Lots of Activity

In addition to homelife, would your Belgian Sheepdog:

 Routine Walks Formal training class Travel with you

More activities for your Belgian Sheepdog:

 Performance events Go to work Playmate for children or pets

References

Please enter your Veterinarian Information (Name, Address, Phone):

Please enter a Personal Reference that is not a family member (Name, Address, Phone):

Do you understand that a visit to your home may be scheduled by a representative of the program and that by submitting this application you agree to such visit?

 Yes No

Do you certify that all the information on this adoption application is true and correct?

 Yes No

Other Information

Please use this space to tell us anything else about you that would aid us in placing a Belgian Sheepdog with you and your family:

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