Dog Adoption Application

Name*

First NameLast Name

Date of birth *

Date

Email*

example@example.com

Phone Number*

Area CodePhone Number

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Are you a applying for a particular dog? If so please name them:

If no to the above, please let us know more about the ideal dog you are looking to add to your family

Breed, age and temperament

Would you consider fostering with a view to adopt?

What is your occupation?

Please tell us in detail, about your work hours and days*

Shift patterns, home at lunch, hours worked

How many hours will the dog be left alone for?*

What provisions do you have in place for leaving the dog? *

Crate, family pop in during the day, a dog walker?

Who else lives in the home? Please state their ages and any dog experience they have*

Do you have children visit regularly? Please state their ages*

How often do they visit? Do they have experience with dogs?

Will there be any changes to your home in the next 6-12 months? moving/baby/renovations/work*

Moving house? Having a baby? Home renovations or change in work hours

Do you or anyone in the home have any medical conditions that we need to know about? This is to help us match a suitable dog to you and provide any rescue back up that you may need.*

If you were unable to care for the dog any longer, what plans would you have in place? Do you know that we provide back up for life?*

Does everyone in the home agree to adopting a dog?

Do you live in a*

If other please state:

Please tell us about your home and surrounding area*

What is your street like? Do you live near a busy road?

Do you*

Own your homePrivate rent your homeRent from other sources

Please tell us who you rent from - A letter of permission will be required*

Please tell us about your garden and fencing in as much detail as possible*

Fence height, type of lawn and any gates

Do you have any holidays booked? Please give us details of your holiday care plans for the dog*

How much exercise and training can you offer a dog? Please give as much detail as possible about your walks and training plans*

Where will you walk, busy or quiet areas? what type of training do you prefer?

What are your expectations of adopting a dog and the life you will then share?

Please give us any information on your experience with dogs*

Previously owned dogs, dogs you have looked after or worked with

Are you able/willing to commit to a dog through any issues that may arise? Please give any details of behaviours you would prefer not to work with

Do you have another dog in the home? Are they vaccinated and neutered? Tell us about their temperament, have they lived with another dog before? what kind of companion would they like?*

Do you have any other pets in the home? Please list them below, are they vaccinated and neutered? Have they lived with a dog before? Do you have any visiting animals? if so please add them to the form too.*

Please let us know where small animals are housed

Are you applying to other organisations also?

Have you ever had to return/rehome a dog to rescue? Please briefly describe the situation*

Please give details on how you will settle a new dog into your life and home*

Think about visitors, where the dog will sleep and other pets

Do you drive*

yesno

Are you willing to travel potentially multiple times to meet the dog?*

YesNoDepends on distance

What distance would you travel?

Are you financially ready for the commitment of a new dog? Will you take out insurance?*

Tell us why you feel you are the right fit for a rescue dog? *

How did you hear about us?

Do you consent to us retaining your personal data obtained throughout the application process for future reference and subsequent applications?This data will not be shared without your prior consent and not used for any other purpose.*

Yes

Please provide TWO references to support your application*

	Full name	Contact details
Reference
Reference

Todays Date*

Date

Please Sign and submit your Adoption application*

New Dog Adoption Application