Adoption Expression of Interest
This is the online version of the Friends of Bush Pups Adoption Expression of Interest (EOI) form, converted from PDF. Please complete all required sections.
Date
*
-
Month
-
Day
Year
Date
Dog Name / Description
*
Name
*
Address
*
Mobile
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Do you own your home or rent?
*
Please Select
Owner/occupier
Rent
Your current type of dwelling
*
House
Unit/Duplex
Apartment block
Rural/Acreage
Is your yard fully fenced?
*
Please Select
Yes
No
How many people live in your household?
*
Are there any children living in your household or frequently visit your home?
*
Please Select
Yes
No
Number of children - Under 5 years old
Number of children - 5 to 10 years old
Number of children - 10 to 15 years old
Do you have other pets?
*
Please Select
Yes
No
If YES, please provide details of other pets (species, breed, age, sex, temperaments etc.)
Are all the pets in your household desexed?
*
Please Select
Yes
No
Will your dog/s be allowed inside your home?
*
Please Select
Yes
No
If your dog/s is kept outside at times what type of shelter and/or shading will be available?
*
How often may your pet/s need to stay alone at home?
*
How many hours would be the average length of time your dog/s may need to be alone at home on any one day?
*
How often would you be able to exercise/ walk your dog/s?
*
If you were away from home on holiday or an overnight trip what arrangement/s are you able to make for your pet/s to be cared for?
*
Do you consent to a Friends of Bush Pups representative contacting you to arrange a mutually agreeable time to talk and/or meet?
*
Please Select
Yes
No
Additional information relevant to your application
Agreement to terms and conditions
*
I agree to the terms and conditions
Signature
*
Name (for signature)
*
Date (for signature)
*
-
Month
-
Day
Year
Date
Submit Expression of Interest
Submit Expression of Interest
Should be Empty: