Adoption Application Form

Adoption Application Form
Date

Day Month Year
Date
Name *

First Name Last Name
Email *
example@example.com
Address *

Street Address

Street Address Line 2

City State

Postal / Zip Code
Phone Number(s) *
Pet You Are Inquiring About *

Pixie - Silky Terrier Female - Mid Nth Coast (NSW/ACT only) Ella - Silky Terrier Female - Sydney (NSW/ACT only) Dillon - Silky Terrier Male - Mid Nth Coast (NSW/ACT only) Angus - Silky Terrier Mix Male - Sydney (NSW/ACT only) Little - Small Crossbreed Female - Mid Nth Coast (NSW/ACT only) Waggs - Small Crossbreed Male - Mid Nth Coast (NSW/ACT only) Expression Of Interest for dog in REHAB
EOI Name of dog in rehab
I Have Read The Pet's Profile In Full *

No YES and I have noted the location and understand I need to travel to the dog.
Other Pets In The Home *
Include species, size and breed. Are these pets desexed?
Family Veterinarian *
Children In The Home Or Visiting *
Amount Of Time Your Pet May Be Alone *
Do You Have A Pet Door Installed? *
Daytime Plans. Include Where Your Pet Will Be When You Are Out. *
Night-time Plans. Include Where Your Pet Will Be When You Are Out. *
Socialisation And Training Plans *
Renters And Body Corporate *
Where Do You Plan For Your New Pet To Sleep? *
Diet And Healthcare Plans *
Prefer High, Medium or Low Grooming Needs *
Prefer High, Medium or Low Energy Pets *
Time Available For Walks And Socialising *
Do You Plan To Use Off Leash Areas? *
Fences, Gates And Boundaries Secure And Lockable *
Is There Access Under The House? *
Is There A Pool Or Dam On The Property? *
Have You Planned For Holidays? *
Your Space To Provide Extra Information. Would You Like To Tell Us About Your Other Dogs? *
I'll remember to check my spam folder for a reply. *
Final Checks *

* I agree to a pre-adoption home visit/yard check * I have read the pet's profile in full *** I understand that providing false information deems this application invalid. --- Failure to check this box may result in no response to your application
Below is a separate section of information if you are applying on someone else's behalf.
Are You Applying For A Friend, Relative Or Client? Please Detail.
The Basics Of Applying For Someone Else

They know I am applying. They have read the pet's profile. They are aware a meet & greet and fence check must be carried out. I have not discussed ownership yet.
If You are Applying For Someone Else Please Provide Relevant Details Such As Age And Activity Levels Which May Be Suited To Certain Breeds/Age Of Dog.
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