DOG Adoption Application Dog Adoption Application Name* Phone* Email* Are you over 18? Yes No Dog/s you're interested in? What state/territory do you reside in? NT SA VIC QLD NSW ACT WA What sort of residence do you have? Unit with yard House Acreage Unit with no yard Do you own or rent the residence? Own Rent If renting, please provide name and number of landlord/property manager as we require proof that you are allowed to have a pet at the premises: What size is your secure yard?* Small Moderate Large If you have a swimming pool, is it fenced? Yes No N/A If not fenced, how will you keep your puppy safe?* How will you keep your new dog safe?* Fully Fenced Yard Enclosed Dog Run Chain Does everyone in the household agree to adopting a dog?* Yes No Not Sure Will the dog be allowed inside?* Never When someone is home In the evenings Always Access via doggy door Where will your new dog sleep?* Inside On my bed Laundry Verandah Outside in kennel How many hours will the dog be without human company for each day?* Are you planning a trip in the short term?* Yes No How often do you travel?* What will you do with the dog when you travel?* Leave at home with food out Boarding Kennel Pet Sitter Haven't thought about it Are you willing to take the time to housetrain a dog and do you understand that changing a dog’s environment may cause the dog to have accidents? Yes No If a behavioral problem arises, what steps will you take to work on it?* Will you take the dog to obedience training? Yes No Who will be responsible for feeding, walking and toileting the dog?* How often will you have time to walk the dog?* Under what circumstance would you give up this pet? Family Illness Barking Digging Shedding Allergic to dog Destructive chewing Moving house Reactive on lead No housetraining High cost vet bills What pets do you currently have? Are they desexed, vaccinated and registered? Currently Vaccinated Desexed Currently Registered Have you had any pets in the past? What happened to them? Have you ever taken an animal to a shelter or released it to another party? Please explain:* Why do you want to adopt a dog, eg companion for yourself /other pet / for children / watchdog?* Is there anything else you would like to tell us about you, your family or your interest in adopting a dog? The more information you provide, the better we will be able to determine suitability of your chosen dog(s)* By submitting this application, I agree that all the information I have provided is correct. Providing untruthful answers or failure to comply with the requirements of this application or the signed adoption contract can result in the forfeiture of the adoption. I agree to allow you to check any references provided. We will require the successful applicant to sign an adoption agreement and allow a property check if requested before adoption. We may also ask to sight your driver’s license before the application proceeds. We appreciate you taking the time to complete this application. Upon review and approval, we will contact you as soon as possible. We appreciate that it is a long application to complete if the application is unsuccessful. We hope by completing it you have found out more about your requirements for a dog. We reserve the right to refuse any applicant and will not enter into any further correspondence on our decision. We are here to find the best suitable home for our pets, sometimes, unfortunately, that may not be you. Submit