Fresh Start Rescue Adoption Enquiry Form

Name of Animal you are applying for. *

Is this animal a dog or cat? *

Dog Cat

First and Last Name *

Street Address *

City: *

State: *

Postcode: *

Home Phone:

Work Phone:

Mobile phone: *

Email Address: *

Please tell us a bit about your family - family members, ages etc. *

Do you Own or Rent your House? *

Own Rent

Renting: Please provide landlords contact details:

Do you currently own any pets? *

Yes No

If yes, please describe them in detail including, type, age, sex and personality.

Are all your pets desexed and up to date with vaccinations, heartworm, flea and worming preventatives? *

Yes No

If no: Please provide details.

Please provide details of the home you have to offer your new dog - i.e. secure yard, fencing height, indoor space, outdoor areas etc. *

Please describe the home you have to offer your new cat - secure home with fly screens on windows, indoor space, outdoor enclosures, etc. *

Have you adopted a rescue cat or dog before *

Yes No

Have you surrendered a pet before? *

Yes No

If Yes: please give details.

What are you looking for in a rescue cat/dog? *

What kind of temperament would you like your new pet to have? (i.e. active, social, easy-going, couch potato, playful etc.) *

Where will your new pet spend its time during the day? *

Where will your new pet sleep at night? Please describe: *

How many hours a day (on average) will your new pet be on its own? *

What will you do with your pet/s if you go on holidays? Please provide details: *

How active is your family? What activities will you do to exercise your new dog? *

Do you plan on taking your new dog/puppy to obedience school? Are you prepared to assist with things like toilet training if required? *

Do you plan to keep you new cat inside at all times, unless secured in an outdoor cat enclosure? *

Yes No

Are you prepared to allow a Fresh Start Volunteer to visit your home as part of the adoption process? *

Yes No

Anything else you would like to tell us?

In case of emergency, who should we contact? (name and phone #)

Are you okay with being added to our database and receiving emails from Fresh Start Rescue?

Please tick this box to allow us to email you