Foster Homes: Please copy information into this Relinquishment Evaluation Form from the Relinquishment Agreement you completed at the time the border collie was signed over to you. Use your Tab key to advance to the next box; just keep typing within a box (except for name & address box), it will take the characters; be as detailed as possible. This information will become part of the dog's permanent file and will serve as the basis for writing their Bios. If you have any questions, please email the Director, or call (517)783-5860. Thank you for all you do for Rescue!
Today's Date:
Your name, full address & Phone # (including Area Code):
Email Address:
Age:
Dog's Name:
Dog's ID# (BCR-MI):
Brief Description/Markings(ear set, coat type, color of chest, legs, tail tip, neck:
Shelter?
Stray?
Owner?
Did this dog come from:
Date Relinquished:
General Information
Does the dog like:
Strangers?
Car Riding?
Water?
Play?
Walks?
Other Dogs?
Children?
Cats?
Other?
What brand of food being fed?
Dry?
Canned?
# of feedings/day?
Amount/feeding?
Has the dog been:
Beaten?
House Dog?
Kenneled?
Dog House?
Loose in yard?
Chained?
Loose?
Tied?
Other?
Yard Full-Time?
Yard Part-Time?
Habits:
Howls?
Signal used?
Runs?
Housebroken?
Signals to go out?
Barks?
Walks nice on-leash?
Gulps Food?
Guards food?
Guards toys?
Likes collar?
Likes leash?
Digs in yard?
Escape Artist?
Gets out to follow children?
Jumps on people?
Jumps fences?
Chews?
Vindictive?
Other?
Tricks?
Explain Briefly
Titles, if any:
Temperament:
Sound Sensitive?
Friendly?
Enthusiastic?
Outgoing?
Suspicious?
Cautious?
Eager to please?
Dog aggressive?
People aggressive?
Stubborn?
Lethargic?
Inflexible?
Other?
Can you add anything to describe the dog's general temperament?
Has the dog ever been exposed to any livestock (i.e. sheep, geese, ducks, cows, horses)? Please explain the circumstances and how the dog reacted.
Has the dog ever bitten a person?
An animal?
Please explain the circumstances and whether or not skin was broken.
Action taken?
Items received with border collie:
Donation check?
Check amount: (Payable to: BCR-MI, INC).
Leash?
Collar?
Toys?
Describe:
Blanket?
Crate?
If yes, crate Brand, size and type:
If no crate, donation to purchase?
Amount (Payable to BCR-MI)
Cash:
Check:
Food for 5 days?
Brand:
Dry?
Canned?
1-gal water?
# of bowls?
Other items? Describe.
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