Expression of Interest to Adopt - Dogs

Thank you for expressing interest in adopting from our facility.

To help us find the best home for our animals, please provide a little bit of information about yourself.

 We appreciate your honesty and understanding.

Personal Details

First Name *

Last Name *

Address *

Street address *Street address line 2

City *

State *Please selectACTNSWNTQLDSATASVICWA

Postcode *

CountryPlease selectAfghanistanAlbaniaAlgeriaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo (Brazzaville)CongoCosta RicaCote d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast Timor (Timor Timur)EcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambia, TheGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea, NorthKorea, SouthKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint VincentSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbia and MontenegroSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamYemenZambiaZimbabwe

Phone Number *

Email Address *

Dog preferences

Do you have any questions about breeds at our facility?

Are you interested in any dogs currently at our facility? *

YesNo

Please provide the name of the animal you are interested in.

About You

What best describes your employment situation?

Full-time employee/self employedPart-time employeeCasual employee (1 day per week/ couple of hours per day)Work from homeRetired/stay at home parentUnemployed

What best describes the type of property where you live

Acreage/FarmDetached HouseTownhouse/Duplex/Granny FlatApartment/UnitOther

 

What best describes the status of the property where you live?

Owner Occupied Rent with landlord approval/strata approvalOther (e.g. Department of housing, private rental, etc) - Please specify

 

Have you owned a dog before?

NoYes, I grew up with dogs / Had them in the family home.Yes, I have owned a dog from a puppy/breederYes, I have owned a dog from a pound/rescue

Have you ever needed to surrender a pet?

NoYes

Please provide further details

Your Living Arrangements

Who is currently residing in your household?

AdultsChildren

How many adults are currently residing in your household?

12345+

How many children are currently residing in your household?

12345+

What is the age range of the children residing in your household?

Do you have any existing pets living in your household?

YesNo

What pets are currently living in your household?

Dogs (breed, age, gender, how long you have had the dog for)Cats (age, gender)Pocket pets Other animals

Tell us more about the dog/s living in your household? (number, breed, age, ownership period, etc)

Tell us more about the cat/s living in your household? (number, breed, age, ownership period, etc)

Tell us more about the pocket pets living in your household? (number, breed, age, ownership period, etc)

Tell us more about the other animals living in your household? (number, breed, age, ownership period, etc)

Living conditions for the dog

Outdoors onlyOutdoors with inside access when someone is homeMostly indoors Free access indoors and outdoors

Yard details

No backyardSmall backyardMedium backyard Large backyardOther

 

Fencing Details

No fencing Low (Up to 1 Meter)MediumHigh (1.8 meters or higher)

Fencing material (if known)

Ability to Exercise

How do you plan to exercise your dog? (select all that apply)

WalkingBush walks, hiking or runningPlaytime and mental enrichment at homeHire a dog walker Doggy daycareWhatever is required for the dog I adopt

How often will exercise and stimulation be provided?

Everyday 2-3 time a weekOnly on weekends Not able to provide exercise and stimulation Whatever is required of the dog I adopt

Before submitting, do you have any further information or have any questions about the adoption process?

I declare that I have answered this form honestly and to the best of my knowledge. *

I declare that I am over the age of 18. *

Signature *

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Today's date *

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