Adoption Application & Agreement
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
-
Area Code
Phone Number
Mobile
Email
example@example.com
Which dog are you interested in adopting? (Place the dog's name in the box below).
Do you currently have pets?
Yes
No
If yes, please provide details of type/age/breed/sex/desexed/vaccinations up-to-date.
Do you have proof of Real Estate/Land Lord permission to have pets?
Yes
No
Not applicable - I own my own house
Do you consent to a property check?
Yes
No
Have you ever been investigated, or convicted of an animal related offence? (Including Council, RSPCA, Police or other authority).
Please provide details if answer is Yes.
Drivers Licence #, State of issue and Expiry Date.
What size is your yard?
What height are your fences?
What are your fences made of?
Do you have gate access? If yes, what height is the gate?
Is there shelter from all weather conditions?
Yes
No
Do you have children living with you?
Yes
No
If yes, please provide their ages
How many hours a day is nobody home?
How many hours will the dog be without human company?
Where will the dog sleep at night?
Inside
Outside
In the garage
Other
If other, please provide details of where the dog will sleep.
Where will the dog be while you are at home?
Inside
Outside
In the garage
Other
If other, please provide details of where the dog will be while you are at home.
This is your time to shine. What else would you like to share with us about you, your home, your family and the kind of life you can provide for a dog.
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DateTime
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