THE NATIONAL BORZOI RESCUE FOUNDATION
If not you than who; if not now than when
Due to continued increases in veterinary care costs, NBRF has recently found it necessary to increase the adoption fees for rescued Borzoi.
NBRF Borzoi under seven (7) years the fee is $400 NBRF Borzoi seven (7) years and older the fee is $200
Due to the high cost of bringing a Borzoi to the United States as well as the increased cost of veterinary care, fees for NBRF-International Borzoi have been increased.
NBRF-Int Borzoi under seven (7) years the fee is $500 NBRF-Int Borzoi seven (7) years and older the fee is $250
Name: ______
Address: ______City: ______State: ______Zip:______
Phone (home): ______(work): ______
Email Address: ______
Occupation:______
Employer:______
How long?: ______Employer's Phone:
If Applicant is not head of household, who is? ______
Occupation:______
Employer:______
How long?: ______Employer's Phone:
TYPE OF RESIDENCE:
House ______Apartment ______Mobile Home ______Condominium ______Other ______
If "Other", please explain:______
Do you rent: ______or own: ______
If you rent, do you have your landlord's permissions to keep a Borzoi? YES ______NO ______
How long at this address? ______
Does your city, town, or county have an ordinance or law limiting the number of dogs you may keep?
YES _____NO_____
If Yes, how many? ______
OTHER PEOPLE LIVING AT THIS ADDRESS (children, relatives, roommates, significant others, spouse, etc)
Please list ages if under 21 years.
NAME RELATIONSHIP AGE
______
______
______
PLEASE LIST ALL CURRENT PETS: (dogs, cats, birds, reptiles, etc)
SPECIES NAME AGE SPAYED/NEUTERED (Y/N) SEX
______
______
______
Where are these pets kept?
Where would you keep a Borzoi?______
What type of exercise would the Borzoi get?______
DOES ANYONE IN YOUR HOME HAVE ALLERGIES? YES ______NO ______
If "yes", please explain:______
DESCRIBE YOUR YARD______
Approximate Size: ______
Fence type and height: ______
How much time would the Borzoi spend outside?______
Have you ever owned a Borzoi before? YES ______NO ______
Or other large dog? YES ______NO ______What type?
What happened to them? ______
Have you ever surrendered a dog to a shelter or taken one back to a breeder?YES ______NO ______
If "yes", please explain:
Would you consider... (rate from 1 to 10, with 10 being the most desirable)
Male ______Female ______Puppy (under 6 months ______Puppy (6-12 months) ______
Over 5 years of age ______From a shelter ______With medical needs ______Untrained ______
Borzoi mix ______Other (Please explain if we have missed something):______
REFERENCES: (please include name, address, phone number and email (if applicable))
Veterinarian: ______
Personal References: ______
Who in your home wants a Borzoi? ______
Who will be the primary caretaker? ______
Would you consider foster care for a trial period? YES ______NO ______
Do you understand that NBRF expects reimbursement of expenses which include spay or neuter, vaccinations,
heartworm checks, and other medical care in the amount of $400 per Borzoi? YES ______NO ______
Will you keep the NBRF informed of any moves, illnesses, escapes, or death of any Borzoi entrusted to your
care? YES ______NO ______
My signature below means all information listed on this questionnaire is correct as I know it now.
______
(Signature) (Date)
Please return this form to your local rescue contact or mail to:
Carol Backers Home: 231-409-2129
7765 Kellogg Rd, NWtoll free:1-844-627-3964 (844-NBRFZOI)
Alden, MI 49612