Application Form

First Name

Last Name

What is your age?

Best contact phone number

Enter your full address

Post Code

If you’re not applying for a certain dog from our Lonely Hearts then please tell us about the dog you are looking for

Please provide details of any family/people who live in the house or are regular visitors/houseguests that regularly stay overnight

Name

Age

Relationship

Name

Age

Relationship

Name

Age

Relationship

If there are children in the family or that visit please detail their experience and confidence levels around dogs

What is your occupation and that of other adults in the house

What are your normal workhours, days or shifts

What provisions will be made for the dog and where will it be left while you are at work or out of the house?

If you were to be away from your dog for days, such as being on holiday what would happen with the dog

What is the longest time a dog would be left alone on an average day?

Do you have any health issues that could impact on having a dog?

Your Home and Garden

(If rented please provide proof of landlords permission to keep a dog)

Please tell us about your garden such as size, fencing/hedges/walls including height, security of gates, does it have hazards such as a pond.

Pets

Do you have any other pets, if yes please provide details such as species, breed, gender, age, neutered/spayed (vaccinations if relevant), character, experience with dogs

If required do you have means of separating animals if needed, if yes, how would this be done

Dog Experience

Have you ever owned a dog before, if yes please provide details such as species, breed, gender, age, neutered/spayed (vaccinations if relevant), character, experience with dogs

Are there any other dogs you have experience with such as family or friends pets:

If yes please give details (breed, gender, character, your role)

What would your exercise regime be for your dog?

How would you deal with unwanted behaviour such as toilet training issues or the dog jumping up at people

Often rescue dogs have had little if any training so can lack manners/ house training or need to reteach them. What are issues you would be willing to work with

What are issues you would NOT be willing to work with

Other

Have you ever applied to another rescue:

If so what rescue and roughly when

Have you ever had to give up a dog in the past:

If Yes, please outline the circumstances and where the dog went to

Are you willing to travel to meet/ pick up your dog, potential with any other dogs and/or children:

Please tell us why you are looking a dog and any other information you feel is relevant

By completing and submitting this form you agree to the following:

I am aware of the £350 per dog adoption donation

If my application is successful, I agree to a home check

Signed

Date required

All adopters must sign an Adoption Contract and agree to the Terms and Conditions of Adoption.All dogs adopted will be microchipped, vaccinated and neutered as per the terms of our contract.

Thanks for submitting!