Stella

SEX: Female

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 Stella?

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

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.

Which dog(s) are you applying to adopt?

Have you read the dog profile and do you/does your home meet all of the criteria?

Yes

Are you willing to visit the dog on a minimum of two occasions in the location, as specified on the dog’s profile page (on the website):

Yes

What is the best time for us to contact you?

YOUR PERSONAL DETAILS

First Name:

Last Name:

Address Line 1:

Address Line 2:

Town/City:

County:

Postcode:

Contact Number:

Email:

If you have any disabilities that may affect how you care for a dog, please give details:

State 'None' if that applies.

YOUR PERSONAL DETAILS

How many adults live in the home and what are their ages?

How many children live in the home and what ages are they?

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).

Are the children in the home used to dogs?

Not applicable

Yes

Other answer

If 'Other Answer', please give details here:

Are all members of your household in agreement with this adoption?

Yes

Ages of any visiting children:

If 'Not Applicable' please state 'None'.

Are all regular visiting children used to dogs?

Yes

Not applicable

Other answer

If 'Other Answer', please give details here:

How would you describe your home?

Noisy

Quiet

Busy

Other answer

If 'Other Answer', please give details here:

Type of home?

Flat

Detached house

Semi-detached house

Mid-terrace house

End-terrace house

Other type of dwelling

If 'Other Type', please give details here:

How would you describe your surroundings/home location?

City

Suburban

Rural

Countryside

Isolated

Other Description

If 'Other Description', please give details here:

Do you live in a ‘busy’ dog area?

Yes

Other answer

If 'Other Answer', please give details here:

Do you have an enclosed and secure garden?

Yes

Other answer

If 'Other Answer', please give details here:

Briefly describe your outdoor space for the dog:

How high is your fencing at its lowest point?

If in a flat or without a garden, please state 'Not applicable'.

Do any of your neighbouring properties have dogs?

Yes

Any other facilities you would use to exercise the dog?

If none, please state 'None'.

Is your property owned or rented, or other? (If other, please describe):

Owned

Rented

Other arrangement

If rented, we will need to see the Landlord's permission to have dogs in the property.

If 'Other Arrangement', please give details here:

How long have you lived at this address?

YOUR EXPERIENCE WITH OTHER DOGS OR ANIMALS

Do you currently have a dog/dogs?

Yes

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 YES, please tell us a little about the breed, sex and age:

If you do have a dog/dogs please confirm they are:

Neutered

Vaccinated

Microchipped

Not Applicable

If no dog(s), please tick the 'Not Applicable' box.

Do you have any other animals in the home? If so, please give a description of each:

If none, please state 'None'.

If YES, are they used to having dogs about them?

Yes

Not Applicable