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Adoption Application
Arkansas Herding Dog Rescue, Inc. (AHBR) is a non-profit adoption and referral service dedicated to placing abandoned herding breed dogs with new, permanent homes. All of the herding breed dogs available for adoption have been temperament tested, spayed/neutered, are current on their shots, and are heartworm checked and/or treated. If a suitable dog is found for you, we do ask for a small adoption fee to help us cover any medical work we ave done for the dog and to help us continue to help other herding breed dogs in need.

To help us find the best match between you and the dogs we have available, please complete this application and then click on the send button on the bottom of the page to submit your application. After a representative has reviewed your application, you will be contacted to discuss any dogs we have available that would suit you. Normally a representative will contact you within 3 days of receiving your application. We do, however, reserve the right to refuse any applicant.
Name:
Address:
City:
State:
Zip:
Home Phone:
Work Phone:
E-Mail Address:
What is the best time to contact you:
How did you hear of us?
Why do you want to own herding breed dog?
What plans do you have for a dog?(ie: Pet, Guard, Obedience, Herding, Agility, Therapy):
Do you consider yourself/family to be active in such a way that it would include your dog? Yes No
Describe activities:
What dogs do you currently have (breed, sex, age)?
Is/are your current dogs spayed/neutered? Yes No
Is/are your current dogs on heartworm preventative? Yes No
What type of preventative?
How many dogs have you had in the last 5 yrs and what happened to the (if you don't still have them) and why?
How do your dogs get along with other dogs:
Have you ever trained in obedience? Yes No
Are you willing to train in obedience? Yes No

Do you own cats?

Yes No
Do they live... Indoors Outdoors Both
Name of your Veterinarian:
Veterinarians Phone Number:
Other References with phone numbers:
1.
2.
3.
Size of your yard:
Fence Height:
Fence Type:
Is your yard completely enclosed? Yes No
If not, please explain how you will handle your dog's bathroom and exercise needs:
Is anyone home during the day? Yes No
Hours the dog would be left alone?
Where will the dog stay during the day when alone?
Where will the dog spend the night?
Do you own/have you used a dog crate? Yes No
If not, are you willing to use a crate? Yes No
What do you do with your pets when you go on vacation?
Ages of children in contact with the dog?
Do you own your home? Yes No
If not, we will need a letter of permission from your landlord to have a dog. Please give the name and address of your landlord:
Please specify which dog you are interested in adopting or what age/sex/color/size of dog you prefer:
Do all parties (if more than one adult in the house) want a dog?
 Yes No
Are you willing to let a representative of AHDR visit your home with an appointment? Yes No
If not, why?

Tell us any additonal information you feel is necessary:

If a dog is placed with me/us, I/we agree to cooperate with AHDR in its attempt to provide a smooth adoption. I also agree to contact AHDR about problems that might arise in the future. Should I/we become unable to care for or keep the dog, I/We agree to contact ARM immediately and return the dog to AHDR for placement elsewhere.

Yes, I/We agree No, I/We do not agree

When you click the send button, this form will be sent via your e-mail server. Once sent, the form may remain displayed. Rest assured your form has been sent. Be certain that you are connected to your e-mail server when submitting the form. If you do not hear from us within 3 days, try contacting us again. Although we prefer using this form, you may also contact us by e-mail.