Arizona Border Collie Rescue > Custom Registration Form

Join Us!

Why Register?

The reason you need to register is to make you eligible to fill out AZBCR Applications.

There are Three (3) Simple Steps in the Registration Process:

1. Register on the website – This provides AZBCR with your contact information (see registration form below).
2. After you register, you will receive an Email to Validate your Registration (We need to know that you are a person, not a bot or a spammer).
You must click on the Link that is provided in the email to complete the registration process.
3. After you validate your registration, you can then fill out an Application.

You MUST follow these 3 steps or you will not be able to fill out any AZBCR applications later.

You must register with our website and agree to our Terms of Use before you can volunteer with AZBCR. Once you have completed your registration, you will be sent an email confirmation. You may review our Privacy Statement to learn how we keep your information private.

Fill Out The Registration Form

Fields marked with » are required.

Account Info:

Provide your Email Address (this will be your Username when you login)

Verify Email Address To ensure you didn't mistype your email address, please re-enter it here.

Password

Password Your password must be at least 7 characters long

Re-enter your Password To ensure you didn't mistype your password, please re-enter it here.

Contact Info:

Name, Address, Email, Phone

First Name

Last Name

Display Name This is how your name will be displayed to others and to us on the site.

Spouse/Significant Other Optionally enter your spouse or significant other's name

Address Your address will be used only if you apply for adopting, fostering or relinquishing

City

State

Zip Code

Cross Streets Please enter cross-streets near your home

Phone Number Please enter numbers only, no characters

Home Phone

Work Phone

Mobile Phone

Best Phone to Contact You

Are You Human?

Please click to verify you are not a robot below:

Agree to Terms of Use

By selecting "I Agree", you agree to the Terms of Use and Privacy Statement for the AZBCR web site.

I Agree.