Illawarra Branch Adoption Application Form

Illawarra Branch Adoption Application Form

AWL NSW Rehoming Organisation Number: R251000222
Adopter first name*
Adopter last name*
Title
I am enquiring about a*

Cat/kittenOther
Name of animal you'd like to adopt or description if general enquiry only, ie female kitten etc*
Your age?*

18-2526-6565+
Email address*
Mobile phone*
Home phone
Work phone
Street number*
Street name*
Suburb name*
State*
Post code*
Do you own any existing pets?*

YesNo
Pet name/s, breed, type, age
Existing pets disposition to other dogs/cats?
Please provide your veterinarians name and phone number
Do you rent or own your home?*

OwnRent
If you rent, do you have permission for an animal?

YesNoI have applied and am waiting on approval
How long have you been at this address?
Cats only, where will the cat be kept?*

We are looking for an indoor only cat (this may include access to a cat enclosure).We are looking for a cat that will have access to a backyard during the day but be locked inside at night.We are looking for a cat that will not require litter trays. ie: It will be able to access the outdoors at night as well.
Have you ever surrendered or rehomed a pet*

YesNo
If yes, please describe circumstances
Who else lives in the home? (please list ages of any children)
Any other information that might help us determine your suitability for adoption?
Conditions of Adoption

1. I am 18 years of age or over

2. All dogs, puppies, cats and kitten have been health checked by a veterinarian as well as desexed, microchipped, vaccinated, wormed and flea treated. All other species have been vet checked and desexed or vaccinated as appropriate.

3. Despite all precautions, some animals may not show signs of illness before adoption. All animals adopted by the Animal Welfare League NSW come with a 21 day health guarantee from the date of sale, for conditions that may arise following adoption. This veterinary service is only available through contacting the shelter or branch of adoption to make arrangements through an AWL approved veterinary practice. Should you require this service, please contact 0498 200 709 for information and veterinary referral assistance. Veterinary fees from other veterinary practices will not be paid.
ID type*
ID number*
Signature*

Clear
Date

DayMonthYear
- By clicking the submit button, I understand that as part of the adoption process AWL NSW Illawarra Branch may conduct a home and yard check if applicable.
- By clicking the submit button, I understand AWL NSW may check my veterinary references.
- By clicking the submit button, I understand there is an adoption fee associated with adoption of a pet from AWL NSW.
- By clicking the submit button, I verify all of the above information is true and accurate.
- PLEASE, do NOT click the submit button if you have not verified with everyone in your home that they want to adopt and you have permission from landlord if you are renting.
OFFICE USE ONLY
Sheltermate number*
Microchip number*
Animal Name*
Gender tick*

FemaleMale
Species tick*

CatDog
Breed

DSHDMHDLHOther
Breed output*
Colour*
Estimated date of birth*

DayMonthYear
Date
Adoption fee*

$300$275$250Other
Arrival tick*

Signed surrender
Desexed*

yesno
Species
Gender*
Adoption fee output
Should be Empty:

Illawarra Branch Adoption Application Form

PLEASE, do NOT click the submit button if you have not verified with everyone in your home that they want to adopt and you have permission from landlord if you are renting.