Application Form Applicant Details: Full Name & Address: Applicant 1 Applicant 2 Telephone: Email Address Home: Mobile: Home: Mobile: DOB: Who else lives at the property? Are their children, if so what are their ages? Who else visits the property on a regular basis i.e. grandchildren? Has anyone living at the property ever been banned from keeping animals or have a case pending? Do you or anyone else in the home have any disabilities or medical conditions? If so, how do you see this impacting on your new dog? Property Details (please tick appropriate) Property Description i.e. Flat, maisonette, house, bungalow. Please state if semi or detached and whether urban or rural Is your property owned or rented? Do you have permission to have a dog: Y/N Landlord Details if rented What restrictions if any are in your lease regarding the keeping of animals? Is the garden secure Y/N General Description of the garden What height is the fencing?
Employment Details Applicant 1 Employers Name & Address: Applicant 2 Employers Name & Address: Occupation: Full Time Part Time Not Working Occupation: Full Time Part Time Not Working What is the maximum time the dog will be left alone on a daily basis? Do you foresee any changes in your personal situation in the next 6/12 months? Assessment Details Have you previously owned a GSD? If not what do you know about the breed? How much do you think it costs to keep a GSD? Why do you want a dog and in particular a GSD? What made you choose a rescue dog? Is there any type (sex, age, colour) of dog you would not consider?
If you have owned a dog before what sort of behavioural problems did you experience? How did you deal with these? Are you willing to take a dog that has behavioural problems? If so what experience do you have? What other pets do you have? What are their temperaments/ages? Do you have other pets that visit/come to stay? How will you introduce your new dog to them? How do you plan to socialise your dog/introduce to other visitors? What problems do you think there might be for the first few days when your dog arrives?
How would you propose to cope with these? What if anything would make you feel you needed to return a dog to the rescue? Can you foresee any problems with the neighbours i.e. do they have children, dogs etc? If it was needed, do you have a secure area when you could keep the dog secluded from the rest of the household? Where will the dog sleep? Where will he/she be exercised? Will the dog be kept inside or outside? Who will look after your dog when you go on holiday?
Will the dog travel with you in the car? What sort of car do you have? How will ensure his safety in the car? Are you willing to have the dog neutered/spayed and microchipped if not already done? How far are you willing to travel to meet/pick up a dog? Reference Details (Please provide address and telephone number) Vet Details: Personal Reference: General Information and Signature I/We confirm that I have read and agree to the Adoption Terms and Conditions and understand that a nonrefundable donation to the rescue of 150.00 must be paid prior to the adoption of any dog. I/We authorise a representative from Southern Counties GSD Rescue to contact my vet and/or personal reference in order to obtain any additional information required to substantiate my suitability as an adopter. I/We confirm that the details contained in this form are to the best of our knowledge true and accurate. Signed:.. Date:.. Applicant 1 Signed: Date:.. Applicant 2 Signed:.. Date:. On behalf of Southern Counties German Shepherd Rescue