Jack 

SEX: Male 
AGE: ? 
LOCATION: ? 
CHILDREN: ? 
DOGS: ? 
CATS: ? 
 
 
 
History: 
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Current: 
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Walking: 
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Travelling: 
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Vets: 
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Health issues: 
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Ideal home: 
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Standard information: 
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Will you adopt Jack? 

Will you adopt Jack? 

If you think you could offer Jack a new home, please complete the application form below. 

Adoption Form 

Adoption Form 

 
 
By completing this form you agree to our Adoption Process and you also agree to Senior Staffy Club passing on your personal details, to a volunteer in order to arrange a home visit. If the adoption is successful your personal information will also be passed onto the Insurance Company to arrange insurance and the microchip company to register the dog’s microchip number to you as the new owner 
 
We require complete honesty in filling in and submitting this form. Please complete as much of the form as you can. 
 
Please do not be offended by any of the questions we ask in our adoption application. This is in an effort to find a perfect match for our seniors and to give them the home they deserve. 
 
YOUR PERSONAL DETAILS 
State 'None' if that applies. 
 
YOUR PERSONAL DETAILS 
PLEASE NOTE: AS PER OUR ADOPTION POLICY, WE ARE UNABLE TO PLACE DOGS IN HOMES WHERE THERE ARE CHILDREN UNDER 5 YEARS OLD, UNLESS WE HAVE A SPECIFIC DOG THAT HAS LIVED WITH YOUNG CHILDREN IN THE PAST (THIS WILL BE SHOWN ON THE DOG'S ADOPTION PROFILE PAGE). 
If 'Not Applicable' please state 'None'. 
If in a flat or without a garden, please state 'Not applicable'. 
If none, please state 'None'. 
If rented, we will need to see the Landlord's permission to have dogs in the property. 
 
YOUR EXPERIENCE WITH OTHER DOGS OR ANIMALS 
PLEASE REMEMBER: IF YOU ALREADY HAVE A DOG, YOU WILL NEED TO VISIT THE DOG YOU ARE APPLYING TO ADOPT WITH YOUR OWN DOG ON TWO SEPARATE OCCASIONS TO ENSURE THAT THEY ARE COMPATIBLE WITH EACH OTHER. 
If no dog(s), please tick the 'Not Applicable' box. 
If none, please state 'None'. 
If yes, please give full details. 
 
MY COMMITMENT TO THE DOG AND ITS ADOPTION 
Please tell us a little about how you plan to look after the dog. 
If No, plase state 'No'. 
If nobody in the household is working, please state 'Not Applicable'. 
Specify travel means - car, walking, bus, etc. 
 
ABOUT YOUR ADOPTION PREFERENCES 
After this date, in line with GDPR, we will delete your data. 
 
By completing and submitting this form you confirm that you have read and understood our Adoption Policy and also the dog write-up and requirements contained therein. 
By entering your name here, we will take that as the equivalent of signing a hard copy form. 
We aim to acknowledge your application within 48 hours.