Stafford Rescue Adoption Request Form

Stafford Rescue Adoption Request Form

If your application is for a particular dog and you don’t hear from Jan after the initial email of acknowledgement, please don’t be discouraged.It just means that a suitable application was received before yours. Due to the large number ofenquiries we receive it is impossible to keep your details on file for more than 2 months and we encourage you to contact Jan: This email address is being protected from spambots. You need JavaScript enabled to view it. every 2-3 weeks to show you are still interested in adopting.

Date ______

Name______

Address______

Email ______

Home Ph: ______Mobile: ______Work:______

Do you work? Yes/No Full time / Part time / From home / Retired

How many hours will the dog be home alone each day? This does not

include the company of another dog. ______

Children? Yes / No If yes ages?______

Single ______Partner______

Do you have other pets? Yes/No If yes please list them

______

If you own chickens or other birds are they in a secure area enclosed with weld mesh?______

Stafford Rescue Adoption Request Form Page 2

If you have a dog what breed?______

What sort of temperament does it have?______

______

Male or female?______

Age______

Is he or she de-sexed?______

Have you owned a Stafford before? ______

Have you researched the breed? ______

Type of property? House / Unit

Do you own your home? Yes/No

If you are renting do you have permission to have a dog in writing?

______

Secure back garden? ______Height and type of fencing______

Will the dog be allowed inside? Yes / No

Will the dog sleep inside? Yes / No - If no, where will he/she sleep?______

Sex of dog required? Male / Female Preferred age?______

Is there a dog on our website that you are interested in, if so please write his or her name? ______