BRTRA Adoption Application

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Thank you for your interest in the Black Russian Terrier for adoption. The Black Russian Terriers available for adoption have not been physically screened. All information on the history, health and temperament of the dog was provided by the current owner or shelter holding the dog. Phone interviews are completed with the custodian of the dog to ascertain as much information about the dog as possible. All known pertinent information will be transmitted to the prospective adopter. The adopter is expected to meet with the current custodian of the dog to make a personal evaluation of the dog's health and temperament. If you do not feel qualified to evaluate the dog's health or temperament, you are expected to have a professional behaviorist, dog trainer or obedience trainer of your choice assist you with the evaluation. A list of local professionals to assist in evaluation can be obtained from your veterinarian.

Owners of dogs to be rescued are given the names of individuals interested in adopting a BRT. Adopters are provided with the names of shelters/owners looking for homes for their dogs. We hope to assist in providing each BRT with an excellent forever home.

We assist in providing locations of dogs seeking homes and invididuals looking for dogs. Therefore, we do NOT:

1. Guarantee the accuracy, completeness, or usefulness of any information provided by the custodian of the dog, or

2. Adopt, endorse or accept responsibility for the accuracy or reliability of any opinion, advice or statement made by any party providing information on the history, health, or temperament of the dog. Under no circumstances will we be responsible for any loss or damage resulting from your reliance on information or other content provided or transmitted to or by any custodian of the dog or individual providing the location of a possible rescue.

*Adoption Applications are kept on file for 12 months from date of submission. Please be sure to include your City AND State in your full address when submitting an application, as incomplete data can result in a delay. This is a Nationwide database for the BRTRA.

Email *

Name (First & Last) *

Full Address (Street Address, City AND State, Zip Code) *

Phone Number *

Email Address *

Primary Applicant's Birthdate (Month, Date, Year) *

YYYY

Name of Main Applicant & Spouse/Partner's Employers *

How many people live in your household (include number and age of adults, number and age of children?

If none, use N/A or write "none".

Is Everyone in your home in agreement to adopt a BRT? *

Yes

Will you (the primary applicant) be the main caretaker of this new dog? If no, please explain in "other". *

Yes

Other:

Please explain your experience with BRTs or any Guardian or Working Breed of Dog. *

Have you previously owned a Black Russian Terrier? *

Yes

Do you currently own any pets? *

Yes

If you currently have pets, please list their names, species, breeds, ages, sex and if they are spayed or neutered.

Please explain what happened to all previously owned pets and the circumstances (died from x, gave away because of x, etc).

What type of problems might you expect with a rescue? Are your prepared to work with these issues, seek qualified training, and give the rescue at least 6 months to adjust to a new family?
*

Please describe your home (single family, apartment, condo) and if you have a secured, fenced yard for your pets? How high is the fence and of what material? Is it an electric fence only, not a physical fence?
*

If chosen for a Rescue BRT, the dog will reside... *

Inside (live in the house/apt/condo with the family)

Outside (in the yard, a kennel run, a kennel building, etc)

Do you have a place in the house (that is separate from other pets) if needed while your Rescue BRT adjusts to a new family?
*

Yes

How many hours will the dog be left at home alone on a normal, average day such as a work/school day?
*

Please provide information on your current veterinarian or one you have used in the past if you do not have any pets at this time. Indicate - Dr & Clinic name, address, phone number and length of time you have used this vet.
*

Please list the names, addresses, phone numbers, and emails of 3 references of persons other than your veterinarian who are not related to you.
*

Disclaimer:
As a part of the approval process and before placing any dog in your home, you will be asked to agree to certain conditions, such as allowing an agent to visit your home prior to and after placement of the dog. BRTRA has the right to remove the dog from your home if we feel you are not properly caring for it, or you are unable to care for the dog for any reason. Also BRTRA does not accept responsibility for any damage to your home, nor is BRTRA responsible for the dog's actions while on your property, and you must keep the dog under your control at ALL times.

Are you in agreement with these conditions?

Yes

Adoption rules *

I have read, understood, and accepted the rules for adoption.

Required

I am not a robot and by typing my name below, I am providing my electronic signature on this BRTRA Adoption Application Form. *

Send me a copy of my responses.

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