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 Under 24 25-34 35-44 45-54 55-64 65+ Partner's age Under 24 25-34 35-44 45-54 55-64 65+ 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? Please select... No Yes Are you planning any changes to your household in the next few months? No Moving home Expecting baby Expecting other pets Holiday If so please give any details Do you consider your household to be Quiet/Noisy/Active/Busy Your dog will be left for Less that 2 hours 2-4 hours 4-6 hours 6 or more hours 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? Please select... No Yes If yes, what is your occupation? About Your Home Type of accommodation House Flat Bungalow Maisonette Shed (please specify floor if you live in a flat) If a flat, which floor Do you own your own home? Please select... No Yes If no, who does? Do you have access to a secure garden? Please select... No Yes How high are all your fences? Do you live on a main road? Please select... No Yes Is your front garden securely fenced and gated? Please select... No Yes In addition to your garden, where would you exercise the dog? Where would the dog stay during the day? Please select... Indoors Outdoors Where would the dog stay at night? Please select... Indoors Outdoors Other Pets Do you own any other dogs? Please select... No Yes If yes, what is the breed and sex of these dogs? Is it neutered? Please select... No Yes 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? Please select... No Yes Have you owned a rescue dog before? Please select... No Yes What was the name of the shelter? What happened to your previous pets? Your Potential New Dog I would like my new dog to: Very important Quite important Not important Like children Be good with cats Like other dogs Be good with livestock Be good with small animals Like strangers Be housetrained Enjoy being picked up Be good when left alone Like Travelling in the car Some of our dogs require further training. Please tick any statement with which you agree. Would you be prepared to attend training classes? Please select... No Yes If no, why not? What size dog are you looking for? Please select... Small Medium Large I need a dog that has already been trained? Please select... No Yes I am a first time dog owner Please select... No Yes I have trained pet dogs before Please select... No Yes I have obedience trained a dog before Please select... No Yes I would enjoy training a dog Please select... No Yes I am an experienced owner and could train a difficult dog Please select... No Yes Are there any breeds you prefer? Are there any breeds you do not wish to home? Would you prefer: Please select... Short coated Long coated I don't mind How much exercise can you give a dog on weekdays? How much exercise can you give a dog on weekends? How active are you? Please select... Very Reasonably Not very Very/Reasonable/Not Very Why are you looking for a dog? Please give any further information to support your application