EmailMe Form - Border Collie Trust GB Rehoming request form

Name *

First Last

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code

Email *

Phone *

Dogs name *

Gender *

Dogs age *

Breed *

Photo Upload *

For collie crosses we do ask you to upload a photograph of your dog please

Where did you have the dog from? *

We always suggest that you speak to whoever you had the dog from and ask for their help in rehoming first. If you had the dog from a rescue they should be able to help faster than anyone else

Which rescue did you adopt your dog from? *

Why do you need to rehome your dog? *

Microchip Number *

PLEASE ENSURE THE MICROCHIP NUMBER IS INCLUDED BEFORE SUBMITTING THE FORM. WITHOUT A MICROCHIP NUMBER WE CANNOT CONSIDER REHOMING. In order to comply with the legal requirement regarding microchipping we have to insist that all dogs we admit are microchipped before admission and that the dog is registered in the name of the person requesting assistance, or they have written permission from the owner of the dog to rehome him/her.

How long have you owned the dog? *

How does your dog behave with other dogs? *

How does your dog behave with other animals? *

How does your dog react with children? *

Please list any medical issues your dog has, we will ask for a copy of the dog's Vet record when a place is offered. *

Please list any behavioural issues your dog has *

Please mention anything relevant - chasing vehicles, causing damage if left etc but also aggression towards strangers and anyone else including members of the immediate family and other dogs/animals. Any issues not mentioned may result in admission being refused if we offer a place

When we are able to offer a place would you be able to make a donation?

The Trust relies on donations and fundraising to carry out the work we do in rescuing and rehoming Border Collies. Any donation that you can offer will be very gratefully accepted.

Are you able to bring your dog to our centre in Staffordshire? *

All the dogs we rescue and rehome are here at our centre in Staffordshire and therefore we ask owners needing assistance to bring their dogs to us so we can discuss the dogs history and temperament in some detail with you personally. Only in very exceptional circumstances can we consider trying to arrange collection.

DATA PROTECTION - Your details will NEVER be passed to third parties. Please confirm you give us the right to receive and store your personal data in respect of reliquishing my dog *

I consent to Border Collie Trust GB collecting my details in respect of relinquishing my dog