EmailMe Form - EXPRESSION OF INTEREST

EXPRESSION OF INTEREST

If you would like to register your interest in an animal advertised on this website, please fill in the questionnaire below.

"Animal Actionist" will then process your submission by either passing your details on to the rescue organisation who has the animal, or direct with owners. The objective being to ensure pets and people are matched up according to compatibility. We will contact you as soon as possible to further discuss the details of the animal you are interested in.

PERSONAL INFORMATION
Name *
First Last
Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Phone Number(s) *
Email *
CURRENT CIRCUMSTANCES
Are you currently a pet owner? *
Yes
No
If yes, please list all animals (type/breed) currently living with you:
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
Detached home on acreage
Detached home on suburban block
Semi detached home
Apartment / Flat / Unit
Other
If "other", please explain below
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
Do you have Shire approval to keep the animal you are applying for (for farm animals) *
Yes
No
Not applicable
If applying for a farm animal, do you have a PIC registered with the Department of Agriculture? *
Yes
No
Not applicable
If yes, please include PIC number below:
PIC
KNOWLEDGE & EXPERIENCE
Animal Applied For *
Please enter the name or description of the animal as seen on the Animal Actionist website.
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) *
Will live in house with family
In a designated yard or pen
Live mainly outside
Live mainly inside
Will sleep outside
Will sleep inside
Other
If "other", please detail below
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:
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.

* Animal Actionist promotes 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 via Animal Actionist are intented as family pets, and therefore the same rules that apply for non breeding of cats and dogs, applies to these animals too.

** Animal Actionist will only advertise domestic pets (such as dogs, cats, guinea pigs, rabbits) that have already been desexed, or will be as part of the adoption process.
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? *
IN CLOSING...
Are you happy for the owner of the animal and/or a representative from Animal Actionist Ltd to conduct a property check to confirm suitability for this animal? *
Yes
No
Any further comments or questions?
Thank you for this submission!
It's wonderful that you want to help one of our featured pets - without people like you, so many animals face a very uncertain future. We will be in contact with you very soon.

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.

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PERSONAL INFORMATION

CURRENT CIRCUMSTANCES

KNOWLEDGE & EXPERIENCE

FINANCIAL COMMITMENT

IN CLOSING...

Thank you for this submission!