Ballarat Animal Shelter Dog Adoption Application

Ballarat Animal Shelter Dog Adoption Application
Name of Dog/dogs applied for:
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Suburb
Do you own or rent?
Amount of residents in the house
Age of children (if applicable)
Size of backyard
Height and type of fences
Amount of hours dog will spend home alone per day
Where will the dog be allowed in the property (outside/inside etc)?
Where will the pet sleep?
Have you ever surrendered an animal before?
Do you own any pets currently? If so, please list species and age
Is your dog de-sexed (if applicable)
Is your dog/dogs currently registered with the Ballarat City Council (If applicable, Ballarat residents only)
Is your dog/dogs microchipped?
Please submit the form when completed and we will attempt to get back to you as soon as possible. We are open 9-4 on weekdays
Should be Empty: