ADOPTION APPLICATION FORM

Transcription

1 NPC 2015/416285/08 Pretoria Dog Rescue ABSA Cheque account Acc no: Branch: Swift code: ABSAZAJJ Dogs are not our whole life, but they make our lives whole ADOPTION APPLICATION FORM The purpose of this application is to assist us in placing the correct dog in the perfect home. If you are interested in a particular breed or have seen a dog on our ing system, please complete the application form and to Liezel Prinsloo and Ina Schütte: Name Address Cell Phone Number Reinette le Roux Reinette.leroux13@gmail.com / Ina Schütte alans@netactive.co.za Liezel Prinsloo liezelradloff@yahoo.com Name or description of dog Please complete the entire form Full name and surname PERSONAL DETAILS ID number Residential Address address Phone numbers Home Work Cell Number of family members in household Number of children in household and ages:

2 PROPERTY DESCRIPTON Garden / ERF size Is there someone home during the day? If yes, who? Do you rent or own? Rent Own If you rent, do you have the landlord s permission to keep a dog/s? NB!!! If you are living in a townhouse complex or sectional title, we require written proof from the body corporate that you are allowed to keep dogs at your residence prior to the adoption. How long have you lived at this current address? Is your yard/garden fenced/walled? Brief description (height etc.) Is there a pool? Is the pool fenced? Are you planning to move in the near future? Does the pool have a cover? OTHER IMPORTANT INFORMATION For what purposes do you want to adopt a dog? Companionship / Family pet Guard dog Working dog Obedience trials/training Where do you intend to keep the dog during the day? Outdoors Indoors What are the sleeping arrangements for the dog at night? Inside the house Garage or stoep (specify) Kennel Other

3 Do you have an existing vet? If yes, who? Vets name Contact details Will you be willing to have a rescue representative visit your home? Do you own any other pets? If so, please list what kind of pets, breeds, ages, last dates they received vaccination and if they are sterilised Do you breed any of your pets? If so, are you a registered KUSA breeder or not? Who cares for your pets whilst you are away on vacation or business? Registered boarding kennels Domestic worker Family Neighbours Other Specify: Preferred sex of dog? Male Female Coat preference? Short Medium Long Size preference? Small Medium Large Breed preference? Is your family active i.e. running, cycling, walking etc? Please tick the appropriate box and specify in detail. Never Once a week Very seldom Daily If there is a specific dog that you are interested in, please list the name of the dog. Also do you have any knowledge or experience with this specific breed?

4 Please tick as confirmation that you are aware of the following: We need to be notified if you are moving house We need to be notified within 24 hours if the animal dies If you no longer want the animal it must be returned to us ONLY We conduct post home checks when needed Please note that we reserve the right to deny an application should there be reason to do so. We also will conduct post home checks if we feel that it is needed. Please note that we charge an adoption fee of R850, 00 to cover basic costs. Fees will include the following after adoption fees is paid in PDR account: Sterilisation (COMPULSORY) Micro-chip 1 st Vaccination Deworming Adoption fee can be paid via EFT on the day that the dog is going home. Proof of payment to be ed to Ina or Liezel please. Bank Details: Ref: Name of Dog Account name: Pretoria Dog Rescue Bank: ABSA Account Number: Branch Code: Comments: If the puppies are too young to be sterilised they have to be returned to us for sterilisation at our vet when the females are 6 months and the males 7 months old respectively. The new owners have the option to sterilise at their own vet however this will then be for their own account and proof of sterilisation will need to be sent to us within 21 days of receiving the request for sterilisation. All animals must be an integral part of the family and sleep indoors (thus inside the house). New owners to inform family members that they have adopted a dog/s from Pretoria Dog Rescue, and that, in the case of them being unable to take proper care of the dog/s anymore, or them passing away and the family do not wish to keep the dog/dogs, him/her/they will be returned to Pretoria Dog Rescue immediately.

5 I undertake to inform members of my family that I have adopted a dog/s from Pretoria Dog Rescue, and that, in the case of me passing away, and the family do not wish to keep the dog/dogs, him/her/they will be returned to Pretoria Dog Rescue immediately. FOR OFFICE USE ONLY Dog adopted on date Sterilised Microchipped (Sticker if applicable) Vaccinated 5-in-1 De-wormed Rabies Kennel Cough By which vet? Date Puppy? When is sterilisation due: DATE FOR STERILISATION: Dog was from (specify and owners details) Stray Emigration case Down-sizing Surrendered Puppy Unwanted Other shelter Property Checker Date check was done