Adoption Form If you are a human and are seeing this field, please leave it blank. Fields marked with an *** are required Your Details First Name *** Last Name *** Email *** Address *** Suburb *** State *** Australian Capital Territory New South Wales Northern Territory Queensland South Australia Tasmania Victoria Western Australia Post Code *** Phone *** Pet Details Which dog are you interested in? *** Why are you interested in this dog? *** Do you have any previous experience with this breed? *** YesNo Briefly explain you experience. *** If we have listed any medical issues or behavioral problems with the dog you are applying for, how would you manage these? Please include and relevant experience. Why do you want to adopt a Rescued With Love dog? *** Pet Ownership Details What sort of owner are you? *** Novice owner (never owned a dog before) Experienced owner (had a dog before) Very experienced owner (had more than one dog or puppy) Professional (dog trainer or similar) Do you have any other pets? *** YesNo List any current pets including sex, age and breed. *** Select all that apply to you existing pet. *** - Sociable, gets on with other dogs, happy to share with other pets - Reserved but social, shy but basically ok with other dogs- Unsure, can like some dogs but not others- Unsocial, does not like other dogs- Friendly with all humans, including children- Likes people but not that interested- Ok with some people but not others- Does not like children- Does not like any humans but you Are all your pets desexed? *** YesNo Please describe the reason your pet is not desexed. *** Have you had any previous pets? *** YesNo List any previous pets including sex, age and breed. *** Have you ever surrendered a pet to a pound or shelter? *** YesNo Please describe the circumstances. *** Why are you considering adopting a new dog? - For your children- As a gift for someone- For protection i.e. a guard dog- As a companion for your existing pet- As a companion for you- Your last pet passed away and the time is right Under what circumstances would you give up your pet? ie death in the family, barking, digging, cost, new baby etc. *** Describe where your new pet will sleep. *** Describe the diet you will provide for your dog. *** Do you have a doggie door that provides 24hr indoor/outdoor access? *** YesNo How often can you exercise your pet? *** - never - once a day - twice a day - more than twice a day Can you commit to providing training either at home or at a dog obedience class? *** YesNoNot Sure If we've mentioned training for this dog, tell us your experience and what training you will provide Please tick what you are able to financially provide for your pet. *** - An annual vaccination- Monthy flea treatment- Monthly Heartworm treatment- 3 monthly worm treatment- Dental work- Vet care in case of accidents- Council Registration- Schooling/training- Accommodation during holidays- Required grooming- $500 adoption fee Your Lifestyle What is your work situation? *** - Part time - Full time - Work from home - Stay at home - Retired How would you describe your household? *** - Quiet, small household, few visitors - Moderate, a number of people in the household, regular visitors - Busy large active household, lots of visitors How many adults live in your house? *** 123456+ How many children live in your house? *** 0123456+ Please list the ages of each child. *** What type of residence do you live in? *** - House/Suburban block - Townhouse - Apartment - Acreage/farm Are you currently renting or in a property with a body corporate? *** YesNo Do you have a letter of proof of permission from the body corporate/real estate agent or landlord, or a contract, allowing another dog? *** YesNo Do you have secure fencing? *** YesNo Please describe your fencing. *** Do you have a pond, swimming pool, lake, river or dam on your property? *** YesNo Please describe the pond, swimming pool, lake, river or dam on your property. *** If you became ill is there someone who can care for your pets? *** YesNo If you go on holiday, what do you do with your pets? *** Do you object to a house check being carried out? *** YesNo Vet Details If you currently own pets or have owned pets in the past please provide your vet's details. Vet Name Vet Address Vet Phone Terms & Conditions Due to the high volume of applications we reserve the right to contact ONLY THOSE WHO ARE SHORTLISTED within 7-10 days of receiving your application. Rescued With Love reserves the right to refuse any application. Legal reasons prevent us from giving reasons as to why your application could be unsuccessful. All information is kept strictly confidential. I agree to the Terms & Conditions. ***
