Title * Title Mr Miss Mrs
Full address *
Postcode *
Telephone Number *
Email *
Hours worked: 1st person * Hours worked: 1st person Full time Part time Retired Not working
Hours worked: 2nd person Hours worked: 2nd person Full time Part time Retired Not working
What is the maximum time the dog will be left on it's own: *
It is recommended that a dog isn't left alone for more than 4-5 hours, are you able to ensure this for a dog and how? *
Reason for wanting a dog: *
Do you have any other animals? * Yes No
If yes, what type / breed:
Sex: Male Female
Age:
Temperament:
Have they met dogs before? Yes No
If yes, what is their response?
What type of property do you have: * House Bungalow Flat Bedsit
Is the property: * Privately owned Rented Andium Homes
How is it enclosed? (ie. Fencing, gate) *
If rented, please provide Name & Tel no of landlord (written permission will be required):
If yes to the above, please provide details (Ages, how often they will visit etc)
Are all members of this property in agreement with this adoption? *
If not, please describe the type of dog you are looking for:
Would you prefer quite an independent dog or a very affectionate dog? *
Would you prefer an active dog or a couch potato? *
Would you like to do extra activities such as going to trick classes, agility or scentwork? *
What type of exercise with a dog do you prefer? *
Will the dog be able to choose where it sleeps or will there be a dedicated area? If so, where? *
Do you have experience dealing with dogs with medical problems? If so, please state: *
Do you have any experience with any of these behaviour/ training problems? If yes, please state: *
