Register Your Interest

Date of Application (required)

Your title - Mr/Mrs/Miss etc (required)

Your First Name (required)

Your Last Name (required)

Your House Name/Number (required)

Your Street (required)

Your Town/City (required)

Your County (required)

Your Postcode (required)

Your Preferred Contact Telephone Number (required)

Your Email (required)

Date you are able to adopt from (required)

Are you planning a holiday or house move? (required)

Have you or any member of your family ever been banned from keeping an animal? (required)

Please describe your home (required)

Please describe the size of your garden if any.

Please give the height and type of your garden fencing/hedging if any.

Where will your dog sleep?

What exercise will be offered?

How long and often will your dog be left in any 24 hour period?

Please give details of your chosen veterinary practice

Will the dog come in to contact with:-

1. Children (your own or visiting)? Please give number and ages

How often? DailyOftenOccasionally

2. Cats and other pets and livestock(please specify species and number)

3. Other dogs in the household:-
Number

Neutered

Age

Type

4. Regular contact with other dogs
yesno

If yes, please specify

Please indicate if you or any family members have allergic reactions to dogs, mobility restrictions or health issues which may have a bearing on the choice of dog.

Please indicate what age of dog you would consider
From to

Please indicate what breed of dog you would consider
CrossbreedPedigree
Preferred Breeds

Please indicate what size of dog you would consider
small (west or smaller)Medium (collie)Large (GSD and above)

Please indicate what sex of dog you would consider
dogbitch

Please indicate what coat length you would consider
shortmediumlong

Please indicate what energy level you would consider
high - endless energymedium - long walkslow - couch potato

Are there any types of dogs that you would not want to hear about

What is your prior experience of dogs?

Please provide any other information relevant to your adoption

What other rescues have you approached and when?

How did you find out about us?

Can we approach you a later date for publicity purposes?
yesno

I agree that the information I have provided is correct
I agree

The data that you provide will be used in accordance with the data protection act 1985 and will not be passed to any other organisation. The details will only be used by Pupcakes Rescue