APPLICATION TO ADOPT OR FOSTER A DOG OR PUPPY

Name & Surname

Mr/Mrs/Miss/Ms/Other

Email Address

Cell Number

Where did you hear about us? Where did you hear about us? Already aware of centre/branch Referred by owner Facebook/Internet Word of Mouth Just Passing Other

You are interested in? You are interested in? Fostering Adopting

You are interested in a dog or cat? You are interested in a dog or cat? Cat Dog

Size of Dog: Size of Dog: Small (eg terrier) Medium (eg Staffie) Large (eg Labrador) Any

Age of Dog or Cat: Age of Dog or Cat: Puppy / Kitten Less than Two Years 2 to 5 years 5 years+

Gender of Dog or Cat: Gender of Dog or Cat: Male Female Any

A LITTLE BIT ABOUT YOUR HOME: Do You: A LITTLE BIT ABOUT YOUR HOME: Do You: Own Rent Written Permission

Do you have a secure Garden? Do you have a secure Garden? Yes No

Please provide details of provisions to prevent escape: (eg. fencing, durawall, won't be let out unsupervised)

A LITTLE BIT ABOUT YOUR FAMILY: Who lives at Home? Number of adults, number of children and their ages:

Any visiting children? If yes, ages?

Frequency of visits: Frequency of visits: Daily Weekly Monthly

Do you own any other dogs? Do you own any other dogs? Yes No

Are they spayed/neutered? Are they spayed/neutered? Yes No

Do you own other pets? Do you own other pets? Cats Birds Other

Have they been vaccinated in the last year? Have they been vaccinated in the last year? Yes No

Do you have any visiting animals eg family/friends cats and dogs)? If so please give details:

A LITTLE ABOUT YOUR LIFESTYLE: How much daily exercise do you expect to give your dog? Weekday __________ hours Weekend __________ hours

How active are you? How active are you? Very Reasonably Not very

How long do you expect to leave the dog or cat alone on a regular basis? ________________ hours. Is this Day or Nigh? How often?

Are you planning any of the following? Moving house or Holiday in the next few weeks?

YOUR IDEAL DOG OR CAT WOULD BE: Be good with cats YOUR IDEAL DOG OR CAT WOULD BE: Be good with cats Very Important Quite Important Not Important

YOUR IDEAL DOG OR CAT WOULD BE: Like other dogs YOUR IDEAL DOG OR CAT WOULD BE: Like other dogs Very Important Quite Important Not Important

YOUR IDEAL DOG OR CAT WOULD BE: Be good with livestock YOUR IDEAL DOG OR CAT WOULD BE: Be good with livestock Very Important Quite Important Not Important

YOUR IDEAL DOG OR CAT WOULD BE: Be comfortable around children YOUR IDEAL DOG OR CAT WOULD BE: Be comfortable around children Very Important Quite Important Not Important

YOUR IDEAL DOG WOULD BE: Be ok with strangers YOUR IDEAL DOG WOULD BE: Be ok with strangers Very Important Quite Important Not Important

YOUR IDEAL DOG OR CAT WOULD BE: Be housetrained YOUR IDEAL DOG OR CAT WOULD BE: Be housetrained Very Important Quite Important Not Important

YOUR IDEAL DOG OR CAT WOULD BE: Enjoy being picked up/petted YOUR IDEAL DOG OR CAT WOULD BE: Enjoy being picked up/petted Very Important Quite Important Not Important

YOUR IDEAL DOG OR CAT WOULD BE: Like travelling in the car YOUR IDEAL DOG OR CAT WOULD BE: Like travelling in the car Very Important Quite Important Not Important

YOUR EXPERIENCE: I need a dog or cat that has already been trained YOUR EXPERIENCE: I need a dog or cat that has already been trained Yes No

YOUR EXPERIENCE: I am a first time dog or cat owner/fosterer YOUR EXPERIENCE: I am a first time dog or cat owner/fosterer Yes No

YOUR EXPERIENCE: I have trained pets previously YOUR EXPERIENCE: I have trained pets previously Yes No

YOUR EXPERIENCE: I would enjoy training a dog or cat YOUR EXPERIENCE: I would enjoy training a dog or cat Yes No

YOUR EXPERIENCE: I am an experienced owner and could train and look after a difficult dog or cat YOUR EXPERIENCE: I am an experienced owner and could train and look after a difficult dog or cat Yes No

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