TEMPLATE ADOPTION APPLICATION FORM

The purpose of this application is to assist us in screening prospective owners.  If you are interested in a particular breed or have seen a dog on our website, please complete the application form and email or fax to  ……………………………………………………. or fax 011 .

SURNAME    

 FIRST NAMES

ADDRESS

PHONE NUMBERS

EMAIL ADDRESS

NUMBER OF FAMILY MEMBERS IN HOUSEHOLD

NUMBER OF CHILDREN IN HOUSEHOLD AND AGES

ADDRESS

GARDEN SIZE (square meters)

Is there someone home during the day?  If yes, Who?

DO YOU RENT OR OWN

IF YOU RENT, DO YOU HAVE THE LANDLORD’S PERMISSION TO KEEP A DOG/S?

HOUSEHOLD SETTING

IS YOUR YARD/GARDEN FENCED/WALLED

ARE YOU PLANNING TO MOVE IN THE NEAR FUTURE?

 Is there a pool?

For what purposes do you want to adopt a dog?

Do You Intend To Keep The Dog

If Outdoors, What Type Of Shelter Will You Provide For The Dog/S?

What Arrangements Will You Make For Your Dog/S Whilst On Vacation?

What Stimulation Will You Provide For Your Dog?

Are You Willing To Have A Rescue Representative Visit Your Home?

 Do You Own Any Other Pets?

Do You Breed Any Of Your Pets?

DESIRED DOG CHARACTERISTICS REQUIRED

Preferred Sex Of Dog

Size Of Preferred Dog

Hair Type Of Preferred Dog

Preferred Breed of Dog

A Light in their darkness

HOPEFUL HOMELESS SPONSORS:

Tarryn Day

Wendy Flint

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