Adoption Application Form

Last Name *

First Name *

Date of Birth *

Email Address *

Physical Address *

City *

Living Status *

Mobile Number *

Residency Status *

Number of people living at the address *

Ages of people living at the house *

Will the dog have regular contact with children under 5, or elderly people *

Why do you want to adopt a dog? *

I am a first time dog owner? *

I need a dog that is already trained *

I have obedience trained before *

I have lots of experience and could handle a difficult dog *

Please provide ALL details of current pets (unless stock, then just name type). MUST include Name, Breed, Sex, Age, Desexed Y/N, Current Vax Y/N, Registered Y/N *

If you answered no to any of the previous questions regarding your existing animals, please provide further information *

Where do your current pets sleep? Where will your new dog sleep? Please be specific eg kennel, verandah, laundry. If inside, which room? *

Which areas of the house/yard will your dog have access to, eg backyard only, backyard and laundry/kitchen etc *

Have you had any pets in the past? What happened to them? Have you ever taken an animal to a shelter or released it to another party? *

Is your yard securely fenced? Describe type of fencing (wooden, wire etc) and height at lowest point. If you have a pool is this separately fenced? *

If no-one is at home, where will the dog stay? Inside or Outside? If the dog is outside, what type of shelter will the dog have? *

How many hours will the dog be without human company for each day? *

How often will you have time to walk the dog? How long for? On or off lead? *

Under what circumstances would you give up this pet? e.g. family illness, barking, digging, shedding, biting, moving house, housetraining, high cost vet bills? *

If you are renting please provide us with your landlords written verification that a dog is permitted

How many dogs are allowed by your council? *

Employment Status *

Name of employer/business *

Age of dog preferred *

Sex of dog preferred *

Size of dog preferred *

Name of dog(s) you are interested in *

Are you willing to come to Auckland to meet the dog *

Emergency Contact - Name, Phone Number, Email *

Do you currently have a vet? If so, please provide us their name and phone number so we can contact them for a reference, together with one personal referee. If you do not have a vet please provide two personal references (must not be living with you). We reserve the right to contact these referees should the application proceed. *

Please tell us about you, your family, hobbies or your interest in adopting a dog? The more information you provide, the better we will be able to determine suitability. *

Is there any further information you would like to attach to support your application?

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Declaration: By submitting this questionnaire, you agree that ALL the information you have provided is correct.