Adoption Application
We need a little information to help us process your application. Some of it is mandatory (red asterix).
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Adoption Application
Your Contact Details
Name
*
First Name
Last Name
Address
*
Address Line 1
Address Line 2
Town
County
Eircode
Phone
*
Email
*
example@example.com
Your Household
Are you over 21 years of age?
*
yes
no
Are you the head of the household in which you live?
*
yes
no
Is the head of the household happy for you to adopt a pet?
*
yes
no
How many people live in your home?
*
Have you got children?
*
yes
no
Please list their ages?
*
Your Residence
Do you own or rent your home?
*
own
rent
Do you have permission from your landlord to adopt a pet?
*
yes
no
Is your home a
*
council
private rental
Is your home a
*
house
apartment
Other
Do you live near a busy road?
*
yes
no
Do you have a garden?
*
yes
no
What size is this garden?
*
small
medium
large
Is your garden secure and fully enclosed?
*
yes
no
I would like to adopt a
*
Please Select
Dog
Cat
Rabbit
Dog Adoption
Are You Ready For a Dog
Have all your family members all agreed on adopting a rescue dog / pup?
*
yes
no
Are your children used to dogs?
*
Is there anyone in the family who suffers from allergies or asthma?
*
Is there anyone in the family who is scared or nervous of dogs?
*
Your Ideal Dog
Why do you want to adopt a dog?
*
What age of dog would you prefer to adopt and why?
*
Would you like to adopt a small, medium or large dog?
*
small
medium
large
Do you have a specific dog in mind, if so please include the name ?
*
Would you like a dog that is:
*
Good with children
Good with cats
Good with other dogs
Please select every option that applies
Are you looking to adopt a dog with low, medium or high energy levels?
*
low
medium
high
You and Your Dog
Have you owned a dog before?
*
Have you ever looked after a dog?
*
Where will your dog be while you are at home?
*
How many hours a day will you be away for eg work ?
*
Where will your dog be when you are NOT at home?
*
Where will your dog sleep at night?
*
Do you have other dogs?
*
yes
no
About Your Current Dog
About Your Current Dog
What age is your dog?
*
Is your dog male or female?
*
male
female
Is your dog vaccinated?
*
Is your dog neutered?
*
Is your dog microchipped?
*
What do you feed your dog?
*
Is your dog used to other dogs?
*
Cat Adoption
Adopting a Cat
Have everyone in your household agreed on adopting a rescue cat or kitten?
*
yes
no
Do you have a specific cat in mind, if so please include the name ?
*
Rabbit Adoption
Adopting a Rabbit
Have everyone in your household agreed on adopting a rescue Rabbit?
*
yes
no
Are your children used to rabbits? (Please note that no child should be left unsupervised with any rabbit)
*
Why do you want to adopt a rabbit?
*
What age of rabbit would you prefer to adopt and why?
*
Would you prefer a rabbit to live indoors with the family or outdoors in a purpose built hutch and run?
*
Have you owned a Rabbit before?
*
yes
no
Have you ever looked after a rabbit before? Give details.
*
Section End
Other Pets In Your Household
Do you have other pets?
*
yes
no
Please list
*
Comments
Please tell us if there is anything else we should know?
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