Collie Surrender Form
Victorian Collie Rescue
Email address *
Owner's details
Name *
Your answer
Phone Number *
Your answer
Email address *
Your answer
Address *
Your answer
Animals details
Pets name
Your answer
Microchip number *
Your answer
Sex *
Desexed *
Estimated age of date of birth
Your answer
Reason for surrender
Your answer
Where did you get your collie from
Your answer
Does your collie live with other animals. If yes, what other animals
Your answer
How does your collie usually behave towards the following situations? (please describe)
Timid, excited, cautious, calms quickly, playful, growly, jumpy, will hide, stays away, licks, bossy.
Familiar people
Your answer
Unfamiliar people
Your answer
Children under 12
Your answer
Familiar dog
Your answer
Unfamiliar dog
Your answer
Cats
Your answer
Does your collie see a vet regularly? (once a year)
Does your collie have any past or present medical conditions?
If yes, please describe and list medications.
Your answer
Does your collies display any of the following behaviours?
Excessive barking?
Destructive behaviours?
Escapes yard?
Surrender declaration *
Required
I am the owner of the above mentioned animal and declare that no other person has any property interest therein. I agree and understand that I am giving up all rights of possession and ownership of the above mentioned animal. I relinquish any claims that I may have on this animal and agree that Victorian Collie Rescue may take any necessary steps in order to re-home this animal. From this day forward I understand that Victorian Collie Rescue do not have to keep in-touch with me about the animal’s progress. I confirm that this animal has not been declared dangerous.

I declare the information I have provided is accurate and truthful, and that Victorian Collie Rescue will not be held liable or chargeable for any false information or misrepresentation that I may have submitted on this form. I further agree and understand that Victorian Collie Rescue will do whatever is necessary for the safety and well-being of this collie.

A copy of your responses will be emailed to the address you provided.
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