EmailMe Form - NHRFA - EXPRESSION OF INTEREST FORM

PERSONAL INFORMATION

Name *

First Last

Address *

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

Phone Number(s) *

Email *

CURRENT CIRCUMSTANCES & ANIMALS

Are you currently a pet owner? *

Yes

No

If yes, please list all animals (type/breed) currently living with you:

Which routine health treatments are your current pets up to date with?

Annual vet check

Dental

Grooming

Vaccinations

Worming/Parasite control

Other

Please select all that apply. If multiple animals, indicate in general or supply information in "other" field.

Living Arrangements *

Own/buying my own home

Renting

Live with parents

No fixed address

If renting or living with somebody else, does your landlord allow for pets in the home?

Yes

No

It's complicated

Dwelling style

How long do you plan to stay in your current living arrangment?

Indefinite

Planning a move

Other

If "other", please explain below

Should you need to move from your current abode, would you take your animals with you?

Yes

No

Don't know

If applying for a farm animal, do you have a PIC registered with the Department of Agriculture?

Yes

No

Not applicable

PIC Number

If yes, please include PIC number above.

It is law that anyone who owns livestock (even if only as pets) should be registered with the Department of Agriculture. You can apply for a PIC at https://www.agric.wa.gov.au/livestock-biosecurity/registering-owner-stock-or-beekeeper

Do you have shire approval to keep this type of animal? *

Yes

No

STOP! Please call your local shire and check whether you can keep this type of animal BEFORE you submit this form. Even if you have a PIC, and even if you already have this type of animal on your property, your shire may still impose limitations on certain types of animals so this is a very important step to take before moving forward with your application. This is particularly important if you are applying for a pig as some shires do not allow them at all or only allow keeping certain numbers.

KNOWLEDGE & EXPERIENCE

Animal Applied For *

Please enter the name or description of the animal as seen on the Animal Actionist website.

Offering to Foster or Adopt? *

Are you applying for a domestic pet or a farm (pet) animal? *

Domestic (eg Cat, Dog, Rabbit, etc)

Farm (eg Cow, Sheep, Goat, Poultry)

Have you owned this type of animal before? *

Yes

No

If yes, please provide a brief history of your experience with this type of animal.

Provide details on how this animal would be housed at your home. (click all that apply) *

Are you experienced in the husbandry needs of the animal you are interested in? (ie; feeding requirements, immunisations and worming, routine vet checks and grooming/maintenance needs.) *

Yes, I'm fully experienced

I have an idea, but need to know more

I have no idea, but keen to learn!

Please provide a brief rundown of the regular husbandry needs you are aware of for this type of animal, below:

Please select below the water sources for farm animals at your property *

All animals are rehomed under the protection of an adoption agreement. This document establishes that the adoptee cannot on-sell or rehome the animal without the express permission of the original owner and/or a representative of Animal Actionist Ltd or Greener Pastures Sanctuary. Do you understand and agree with these terms? *

Yes, I agree with this fully.

Yes, but I'm not happy with this and would like to discuss further.

No, I cannot agree to this term.

The aforementioned adoption agreement also allows for a trial period that allows for the interests of the animal and adoptee to be assessed. If for any reason the adoption is not working out, the animal is to be returned to the original owner or Animal Actionist Ltd or Greener Pastures Sanctuary. Do you understand and agree with these terms in principal? *

Yes, I agree with this fully.

Yes, but I'm not happy with this and would like to discuss further.

No, I cannot agree to this term.

Do you acknowledge that this animal is not offered as a breeding animal, and in the case of animals that may not be sterilized (specifically some farm animals), do you give your assurance that you will never breed from this animal? *

Yes, I agree with this fully.

Yes, but I'm not happy with this and would like to discuss further.

No, I cannot agree to this term.

This section applies predominantly to farm animals and birds, so if the animal you are applying for is already desexed or will be as part of the adoption process, please still provide an answer that represents your point of view.

* We promote non breeding of all rescued animals, particularly in the interest of breaking the cycle of unwanted farm animals (most of them males,) that find themselves with little time to find a new home and end up in danger of slaughter. All farm animals adopted are intented as family pets, and therefore the same rules that apply for non breeding of cats and dogs, applies to these animals too.

FINANCIAL COMMITMENT

Are you willing/able to pay an adoption fee (if applicable) that would cover any required medical treatments such as desexing, immunising, worming, etc? *

Yes

Maybe - it depends on how expensive it is

I cannot afford to pay an adoption fee

Adoption fees usually cover the medical treatments and upkeep of the animal that is currently being held by rescue organisations. These fees usually work out to be considerably cheaper than buying an animal from a breeder or pet shop and getting the procedures done independently.

Are you able to afford vet treatment in the event of accident, injury or disease? *

Yes

Maybe - it depends on how expensive it is

I'm on a very tight budget, I may need help with fees.

Some organizations offer discounted vet services to people on low incomes. Should you need assistance, we can direct you to these service providers.

Do you use a regular vet? Can you tell us about your veterinarian, who they are? Distance from you? Do they treat farm animals? *

If you are happy for us to contact your vet to obtain a referral, please provide their telephone number and preferred vet to contact.

IN CLOSING...

Are you happy for the owner of the animal and/or a representative from NHFRFA's to conduct a property check to confirm suitability for this animal? *

Yes

No

Any further comments or questions?

YOU CAN UPLOAD UP TO 3 PHOTOS TO SUPPORT YOUR APPLICATION: Photo's of intended pens, yards, fencing and land are most helpful.

Upload photos

If you have trouble uploading to this application form, please send photos seperately to info@animalactionist.com

Thank you for this submission! Please read the following important information:

Animals rehomed via NHRFA (Animal Actionist Ltd & Cooperatives) generally come from wide variety of locations and their past treatment and history is often unknown. Whilst we take steps to ensure that animals receive routine husbandry treatments before handover (such as worming, castration (when needed), vaccination, etc), NHRFA cannot vouch for a clean bill of health nor are we in a position to guarantee that animals are not carrying or previously exposed to infectious disease. Furthermore we often cannot give a full background/understanding of animal's behavioural traits with people or other animals. Therefore NHRFA (and their agents) cannot be held responsible for any damage or harm caused by the animal/s to any property, animal or person during the period of foster or adoption.

PS: Rest assured that submitting this form does not commit you to adopting, nor does it promise you can adopt the animal you are enquiring about. This is a first point of contact form, designed to garner important information that will enable us to place animals in appropriate homes. We take this first step in the interest of helping both the animals in question, and the people who wish to adopt them. Final decisions will be made by all parties after this application is submitted and appraised.