EmailMe Form - Expression of Interest to Adopt

Name *

First Last

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Phone *

### - ### - ####

Email *

Which pet are you interested in? *

How many people living at the premises? Children? Ages? *

Why do you want to adopt this pet? *

How much experience have you had with animals? *

Novice pet owner (never owned a pet before)

Some experience (have had a dog/cat before)

Very experienced (have had more than two dogs/cats before

Do you have any other pets at home? If so, please tell us about them. *

Are your other pets desexed and vaccinated? (Or were past pets desexed and vaccinated?) *

Where do your pets sleep? *

Where will your new pet sleep? *

Do you work: *

On average how many hours a day will your new pet spend at home alone? *

Where will your new pet stay when you are not home? *

Does anyone in your household NOT want a pet? *

To your knowledge, Is anyone in your family allergic to animals? *

Where will your pets stay when you go on holidays? *

(For a dog) Please describe your fencing. *

Do you have a swimming pool? If yes, will the pet be fenced away from it at all times? *

(For a cat) Is your home fitted with screens? *

Will your pet be living: *

Inside

Inside/outside

Outside

Please describe the type of diet you currently provide for your pets and the diet you will provide for your new pet. *

Under what circumstances would you give your pet up? i.e.. Death in the family, barking, digging, new baby, move house, etc. *

Do you understand that cats and dogs can live 10-20 years? Are you willing to take responsibility for your pet for that long and keep it up to date with annual vaccinations and parasite prevention? *

Please tick what you are able to financially provide for your pet: *

Will you be able to afford veterinary treatment if your pet becomes ill or injured? (Please remember that this could be several thousand dollars) *

How will you look for your pet if it becomes lost? *

Do you own or rent a home? If renting, are pets allowed? *

Do you presently have a vet? If yes, what is their name and number? *

Have you ever had to rehome a pet in the past? If so, what where the circumstances? *

Is there anything else you would like us to know in regards to your application?