Name* Address* Phone Number (Landline) Phone Number (Mobile)* Email* Email (again for verification)* Information about you and your family Please fill a little more information about your family and circumstances How many adults are in the home and what are their ages? (Please seperate the ages by a comma eg. 32, 35, 58 etc)* Is anyone currently pregnant or planning on starting a family soon?* —Please choose an option—YesNo Do you have any children?* —Please choose an option—YesNo Children (if relevant) how many, what age and what dog experience do they have please?* Visiting Children - eg step-children, grandchildren, neighbours, friends - please state ages and dog experience.* Does anyone in the home suffer from any allergies? If so please state* Working hours of all adults in the home PLUS travelling time to/from work* Area all adults committed to the home check, travelling to kennels (please check location and distance before applying!) and spending time and effort on introducing a dog to your home? Who would be the main carer? How long would you expect a dog to take to settle in?* How long would the dog be left home alone for?* You should expect to empty your diary and have your normal routine disrupted whilst you settle in a rescue dog to your home - is this feasible?* —Please choose an option—YesNo If your house is rented, you will be required to provide written permission from the landlord or housing association BEFORE being home checked- are you able to do that?* —Please choose an option—YesNoNot applicable Do you expect your circumstances to change in the next 6-12 months? (eg. moving house / changing jobs / having a baby)* —Please choose an option—YesNoNot applicable Information about your experience with dogs (past/present) Please tell us, in detail, about any pets you may have. Any resident dogs - please state their breed, their age, their gender and make clear if they are neutered or not. Resident dogs would be expected to travel to kennels with the family to meet any potential new dog. Please check the distance and journey before answering this question. Are you willing to do so?* —Please choose an option—YesNo Any other pets? Please state type, age and housing arrangements. What previous experience do you have of owning a dog? Please give details. How much exercise are you able to give a dog on a daily/weekly basis? Where would this be? Is your garden secure and ready to be inspected by our home-checker? Area all fence panels safe, can gates be bolted, ideally all should be 6' high. Please check your garden is dog proof and hazard free BEFORE applying. What measures can you take to ensure maximum safety and security of a dog in your garden? Have you had a dog at this address recently? We will need details of your vet and permission to take up a reference if required - Do you consent to that? —Please choose an option—NoYesNot Applicable What is the name of the Vets you are / would be using? Vet Practice Name Vet Practice Contact Number Vet Practice Number How would you describe your preferred past times? Active? Outdoors? Indoors? Busy with childrens hobbies? Have you ever owned a dog with behavioural issues? If so, what and how did you deal with it? Please give details. Have you ever adopted from a rescue before? Would they provide a reference for you if asked? Have you ever rehomed a dog? Returned a dog to rescue? Euthanised a dog for behavioural reasons? Which dog are you interested in and what is it about this dog that appeals to you? Have you investigated training classes locally? If so, who would you use? Have you considered the cost of keeping a dog healthy - eg vet bills, insurance, unexpected expenses, providing a decent quality diet for your dog?* —Please choose an option—YesNo If you are enquiring about a young dog/puppy you will be responsible for having it neutered at an appropriate age at your expense - are you willing to do so?* —Please choose an option—YesNo Are you prepared to travel to the rescue to meet a dog and bring your family and resident dog with you? PLEASE check the journey / distance / time before you apply.* —Please choose an option—YesNo How soon are you hoping to adopt? Please plan at a time when you can clear your diary and take time off work if necessary. Do you have any holidays or time away planned in the next few months? Information about the dog you're interested in rescuing Please tell us why this dog appeals to you? What is the name of the dog you are interested in adopting?* Are you ready to be home checked by one of our volunteers who will contact you by telephone to arrange a convenient appointment to visit? Please check re garden and any references required first before answering* YesNo Is there any further information we should know about you with regards to your application to adopt a dog? Do you have any previous experience of this breed/type of dog?* YesNoNot Applicable If not, have you done any research on the breed and understand about any specific needs the breed might require?* YesNoNot Applicable Are you aware of the dog's current location in rescue and are you prepared to travel (with any resident dog you might have) to see him/her? YesNoNot Applicable Have you read our adoption terms and understand that an adoption fee is payable?* YesNoNot Applicable Have you read our 'Are you rescue ready?' article and do you agree to it? YesNoNot Applicable Would you be prepared to work with one of our Behaviourists if necessary?* YesNoNot Applicable Where did you hear about us? One Final Question! Because our main concern is rehoming the dogs to people who are genuinely ready to accept a rescue dog into their life - please make sure you have answered all questions correctly. That you are sure that you are not aware of any change in your circumstances in the next 12 months. You are not moving house, not having children within the family, not considering fostering children, not starting a new job, etc. It is CRITICAL that you are prepared to allow a dog time to settle. Please do NOT apply to adopt if you are not able to clear your diary and devote time to settling a new dog in. Please do NOT apply if you are not willing to work with the dog to help them settle. Please do NOT apply unless you are willing to commit (with the help of our behaviourists) to working through any issues the dog you are rescuing may have. We really need to know you are ready to take the rescue dog into your home and make it a furever. We will help and support you with this but YOU must be prepared to do the work to help the dog adapt. Please tick this box to say you agree. Yes