Shelter Relinquishment Request

Relinquishment Form

Humane Society/Shelter Employee Form This form is for use by Humane Societies and Animal Shelters who wish to transfer a Border Collie to our care. Please complete the following information to the best of your ability. All information provided is used solely for the purpose determining how we might help the dog you are contacting us about. * We cannot process your request without photos. *
Contact Name:
Email Address:
Phone #:
Facility Name:
Facility Location:
Dog's Name/ID:
Dog's Age:
Gender:
History:	Stray Owner Relinquishment Unknown
Reason for relinquishment (if known):
Urgency:
Apparent health status / condition on pick-up:
Vaccination status:
Is this dog a purebred or a mix?	purebred bc bc mix
If this is a mix, what breed characteristics do you see?
Dog's behavior in run:
Behavior towards other dogs:
Behavior towards people:
Commands known:
Known background:
If a rescuer does not contact you within one week of your submitting this application, please email our incoming coordinator at rescue@greatlakesbcrescue.org .