Dog Application Form

Name

First

Last

Email

Phone

Address Line 1

Address Line 2

County

Postcode

Date of birth

Profession

How many adults live in the home

How many children live in the home and what are their ages?

What relation are the other people in the home to yourself? i.e. family, flatmates etc

How many children visit, how regularly, and what is their age-range?

Does anybody in the home suffer with any allergies to animals?

What type of home do you live in?

House

Flat/Apartment

Bungalow

Other

If you live in a flat/apartment, what floor do you live on?

Does your home include any communal areas? i.e. entrances shared with neighbours?

Do you have a garden or a yard?

Is your garden/yard private or shared with a neighbour?

Is your garden/yard fully secured, and how?

Is your property owned or rented?

Owned

Rented

If your property is rented, we will need to see written permission for you to rehome a dog; are you able to provide this?

How would you bet describe the area you live in?

Does your front door open onto a busy road?

Where do you plan for your dog to sleep?

Do you plan to let your dog on the furniture?

Yes

No

Do you plan on restricting access to any areas of your home to your dog?

How many hours, on average, will your dog be left alone during the day?

What are your plans for the dog when they are left alone?

What is your plan for exercising your dog?

How do you plan on mentally enriching your dog?

Where will the dog go to the toilet?

Are you happy to employ a dog walker if necessary?

Are there any other animals in the home?

Yes

No

What type of animal?

How old are they?

What sex are they?

How long have you owned them for?

Are they neutered?

Are they up-to-date with their yearly booster vacciantions?

Have they ever lived with another dog?

How do they typically react to other dogs outside the house?

How do they typically react to dogs inside the house?

How would you best describe your home lifestyle

Organised chaos. A bustling, noisy, none-stop life full of fun both in and out of the house.

The simple life. A quiet and calm home with not too many comings and goings.

Social butterflies. Enjoy a busy social life both in and out the house.

Stickler for routine. A well planned and organised lifestyle full of structure and routine.

Please provide any further information about your lifestyle and how you feel it could benefit a dog.

How would you best describe your activity levels?

Adventure crazy adrenalin junkies. Love to hike the hills and clock up the miles!

Weekend rambler. Spend days off enjoying long countryside hikes and visits to dog friendly places.

Sensible saunter. Enjoy leisurely strolls with the dog through local parks and beaches.

Happy at home. Enjoy short walks around your neighbourhood, but prefer snuggles on the sofa.

Please provide any further information about your activity levels and how you feel it could benefit a dog.

What would a typical day look like for your dog?

Somebody at home all day to fuss and play with the dog.

Somebody at home all day but working/busy so dog would need to settle.

Various people coming and going throughout the day, dog would be left couple hours here and there.

All adults working outside of the house – dog would be left alone for the majority of the day.

Adults working opposing shifts so dog would not be left often/at all.

Please provide any additional information on how your dog would be cared for throughout the day.

Tell us a little about your perfect pooch. We know you would ‘take them all’ if you could, but it is so vital we put the right dog in the right home. The more suitable the match, the higher chance we have a successful rehome, s o please, be as honest as you can about what type of dog would suit your home best.

Size:

Age:

Sex:

Male

Female

No preference

Must be good with:

Would you consider a pair of dogs?

Yes

No

Activity and energy levels: What energy levels are you hoping for from your new pooch?

Boisterous buddy full of fun and mischief

Happy hiker – ready to trek for miles

Best of both worlds – enjoys an adventure but loves snoozing on the sofa just as much.

Couch potato – looking for low energy strolls, much preferring chilling on the armchairs.

Have you rehomed/rescued a dog previously?

Yes

No

Training and behaviours: What level of experience do you have as a dog owner?

First time dog owner, never had a dog.

First time dog owner but have been brought up around dogs.

Have owned a dog previously.

Have owned several dogs previoulsy.

Training and behaviours: What level of experience do you have with training dogs?

Beginner – happy to learn basics

Beginner but with a keen interest in learning training techniques

Have trained my last dog to be well mannered

All my dogs have been well-behaved so never had to bother.

Experienced owner having trained many dogs beyond the basics

Training and behaviours: What level of experience do you have of managing behavioural issues?

None – I would prefer to not have to manage difficult behaviours

None – but happy to learn and work with a dog’s needs

I have managed challenging behaviours previously but would prefer not to again

I have managed challenging behaviours previously and up for a challenge again

I feel confident I could manage these behaviours:

Are there any specific traits you are looking for, or wish to avoid, in your new dog? Please provide details.

Have you ever had to surrender ownership of an animal?

Yes

No

Some of our dogs will leave our care with pre-existing conditions that will impact insurance options and costs; are you happy to consider such cases?

Yes

No

Some of our dogs will leave our care needing regular medications and treatments,; are you happy to consider such cases?

Yes

No

Some of our animals may leave our care on specific diets and requiring particular foods, are you happy to consider such cases?

Yes

No

What veterinary surgery would you be hoping to use?

Are you expecting any of the following?

If yes to any of the above please provide details:

Are you ready to rehome straight away?

Yes

No

If no, when would you be ready?

Is there any further information you wish to include to support your application?

Please tick if you are happy to receive further information from Newcastle Dog and Cat Shelter by:

Data storage:

I am happy for my application to be stored in order to be contacted for potential matches.

Declaration

I confirm I am 18 years or over and all of the information I have provided is correct to the best of my knowledge.

Basket

Dog Application Form