STAFFY RESCUE ADOPTION QUESTIONNAIRE

Staffy Rescue is located in north western Sydney NSW Australia. All dogs are available for adoption from our shelter. You must be prepared to travel to our shelter to meet the dog in person prior to adopting one of our dogs. Due to current BSL laws some dogs may not be able to be homed interstate.

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I /We am/are willing to travel to Staffy Rescue in Sydney NSW as part of my /our adoption application and I/we will allow Staffy Rescue to conduct a home check prior to the approval for adopting any dog I/we are NOT willing to travel to Staffy Rescue shelter in Sydney NSW as part of my/our adoption application and I /we will not allow Staffy Rescue to conduct a home check prior to the approval for adopting any dog.

Full Name *

First Name Last Name

Age *

E-mail *

Address *

Street Address

Street Address Line 2

City State / Province

POST CODE Country

Phone Number - Home *

Area Code Phone Number

Phone Number - Mobile

Area Code Phone Number

Phone Number - Work

Area Code Phone Number

Are you employed? *

Full time Part time Student Unemployed Retired

Do you live in a: *

Do you: *

Own Rent Live with Parents

If you are living in rented premises or a strata/community unit, please confirm that you have permission to keep a dog from your landlord or the body corporate.

How many adults live in your home? *

How many children live in your home? *

What size is your yard *

small medium large no yard

How will you keep your new dog secure and safe? *

Yard is fenced Tying or Chaining dog up Training Don’t know yet

Will your new dog have access to the house, or will it be confined to the yard at all times? *

Staffy Rescue requires your home to have fences a minimum of 1.8m (6ft) high. (a home check may be required to confirm this) *

my fence is 1.8m (6ft) high my fence is 1.5m (5ft) high my fence is 1.2m (4ft ) high

what are your fences made from *

timber Colorbond wire brick

Do you have a pool? *

Yes No

If so, please confirm that the pool is fenced and dog safe

Do you have a a dog door? *

Yes No

Is your motor vehicle air-conditioned? *

Yes No

Have you ever owned a dog before *

Yes No

If yes, what kind of dog (or dogs) have you owned before?

Where is that dog now?

How active would you like your new dog to be *

Quiet as possible Moderate activity. Fairly lively Energetic

How much daily exercise will you be able to give your dog? *

None up to 30 minutes up to an hour or more. a couple of times a week.

How many hours per day will the dog be home without a human there? *

eg. 8 hours per weekday

Do you plan on letting your new dog off leash in public parks/play areas?

Where will your dog sleep? *

If you have not owned a Staffy or large breed dog before, have you had experience with these dogs – eg. Lived in a home with a Staffy?

Have you ever had to rehome a dog? If so, can you briefly explain the circumstances?

Do you have other pets *

dog cat rabbits chickens no

If yes please specify how many, types, sex and ages.

What will be your new dog’s main role? *

Child’s Pet Family Pet Adults’ Companion To keep another dog company Guard Dog

Will your new dog be living with very young or very elderly people? If yes, please briefly explain

Will your dog be around inexperienced dog people – eg. Young children regularly visiting your home? *

Yes No

If yes please explain

Size of dog would you like (choose more than one if desired). *

medium large very large (eg bull mastiff) any size will do

What gender would you prefer *

male female dont care

What age dog are you looking for? *

Do you have any concerns about adopting a dog, or more specifically concerns about adopting a staffy or large breed dog? *

yes no

if yes please briefly explain

Do you plan to keep your dog for the whole of its approx. 15 years of life?

Yes No Not sure

Is there a particular dog (or dogs) you saw on the Staffy Rescue website that you would like to see? Please give name of dog (dogs)

Adopting a dog is a life time commitment. Choosing the right dog, the dog that best suits your needs and lifestyle, is therefore very important. The purpose of this Questionnaire is to assist Staffy Rescue in choosing the right dog for you.

It may be that after speaking/meeting with you, we decide that none of the dogs currently at the Staffy Rescue shelter is the dog for you. If this is the case, we will be honest and tell you this. But we would also like you to keep looking at the Available Dogs on our website – dogs are regularly coming and going and it is likely that a suitable dog will come into the shelter before very long.

We endeavour to answer all enquiries within 7 days of receipt.

By sending this electronically, I acknowledge that I have completely read this questionnaire and comprehend it fully. I certify that the above information is correct, and I understand that the information will be verified.

We thank you for taking the time to answer these questions.

Date *

Day Month Year

Your name *

Co-Applicant name (if applicable)

please sign to confirm that all details you have provided are true and correct *

Clear

ADOPTION ENQUIRY FORM