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Humane Society/Shelter Employee Form

This form is for use by Humane Societies and Animal Shelters who wish to transfer a Border Collie to our care. Please complete the following information to the best of your ability. All information provided is used solely for the purpose determining how we might help the dog you are contacting us about.

Unfortunately, we often do not have foster space available to immediately take in dogs that are not in imminent danger. We offer the following help right away: 1) We will the dog to our waiting list for available foster space. If you will provide all available information on the Relinquishment Form below, a volunteer will contact you as soon as possible to discuss what sort of foster care the dog will require. In addition, please send pictures (head front, and body profile) to Donna. 2) We are happy to assist with your rescue and placement efforts by providing exposure for you BCs or BC mix on the MBCR website, on our Also Needing a Home page, with a link to your email and/or phone number for inquiries.

Contact Name:

Email:

Phone:

Facility Name:

Facility Location (City/State):

Dog's Name/ID:

Dog's Age:

Sex:

Stray?

Owner Relinquishment?

Urgency:

Reason for Relinquishment (if known):

Spayed/neutered? (yes/no)

Apparent health status/condition on pick-up

If this is a mix, what breed characteristics do you see?

Dog's behavior in run:

Behavior toward other dogs:

Commands Known:

Behavior toward people:

Known Background

If a rescuer does not contact you within one week of your submitting this application,
please email our Relinquishment Coordinator.

MidAmerica Border Collie Rescue is a 501(c)(3) non-profit organization