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Homing a Dog Application Form

Please complete this form and we will contact you.

Name of dog
	Please note that if you are not successful with your application, we retain your application for 2 weeks.

About your Household

Your name
Partner's name
Address
Postcode
Home number
Mobile number
Email
Your age
Partner's age
Ages and relationships of other adults living at home
Ages and gender of children in the home
Ages of children who visit your home
How often do these children visit?
Are these children used to dogs?
Do any family members suffer from allergies/asthma?
Are you planning any changes to your household in the next few months?
If so please give any details
Do you consider your household to be	Quiet/Noisy/Active/Busy
Your dog will be left for
How often will the dog be left?
Who will be caring for the dog during the day?
Will your dog go to work with you?
If yes, what is your occupation?

Type of accommodation	(please specify floor if you live in a flat)
If a flat, which floor
Do you own your own home?
If no, who does?
Do you have access to a secure garden?
How high are all your fences?
Do you live on a main road?
Is your front garden securely fenced and gated?
In addition to your garden, where would you exercise the dog?
Where would the dog stay during the day?
Where would the dog stay at night?

Do you own any other dogs?
If yes, what is the breed and sex of these dogs?
Is it neutered?
What is your opinion on neutering?
Do you own any other pets? Please give details such as type, age and where they are kept
Have you owned a dog before?
Have you owned a rescue dog before?
What was the name of the shelter?
What happened to your previous pets?

Some of our dogs require further training. Please tick any statement with which you agree.

Would you be prepared to attend training classes?
If no, why not?
What size dog are you looking for?
I need a dog that has already been trained?
I am a first time dog owner
I have trained pet dogs before
I have obedience trained a dog before
I would enjoy training a dog
I am an experienced owner and could train a difficult dog
Are there any breeds you prefer?
Are there any breeds you do not wish to home?
Would you prefer:
How much exercise can you give a dog on weekdays?
How much exercise can you give a dog on weekends?
How active are you?	Very/Reasonable/Not Very
Why are you looking for a dog?
Please give any further information to support your application