DOGTOWN SA - ADOPTION APPLICATION Name of Dog(s): Date of application: Welcome to DogtownSA s adoption programme. We request the following information so that we can assist you in the selection of a new family member. This form, along with a consultation with a DogtownSA representative, is designed to help you find the dog most compatible with your lifestyle. NB. Completion of this application does not guarantee adoption of a DogtownSA dog. Please take note of the below criteria BEFORE you start with the adoption application: To be considered as an adopter, you must comply with the following: All dogs have to be an integral part of the family We only home our dogs to homes where all their existing pets are sterilised Applicants must be 21 years of age or older (provide proof of identification) Applicants must provide proof of current address Applicants must have the consent of your landlord in writing (if applicable) Applicants must be able and willing to spend the time and money necessary to provide training, medical treatment and proper care of the dog All dogs / puppies are sterilized, fully vaccinated, micro-chipped and dewormed BEFORE going home. To help us cover these costs, we do ask for an adoption donation of R850 for puppies and R650 for adult dogs. Name and Surname APPLICANT CONTACT DETAILS Current Physical Address Contact Numbers Land Line Cellular phone (Home / Work): E-mail Address Page 1
YOU AND YOUR HOUSEHOLD Please list the Identity Number s of all adults in the household. Employer & Occupation 1. 2. 3. 4. Type of working hours (what time do you normally leave your home in the morning and at what time do you return) Do you work on weekends? Hobbies? Please list Do you participate in any sport or other outdoor activities? If you enjoy outdoor activities away from home. Do you take your dogs with? Married / divorced / living with someone / single How often? How often do you go on holiday & weekend breakaways? Do you take your dogs with you when you go on holiday? What relationship have you had with past dogs, and what kind of relationship do you want from the new dog(s)? LIVING SITUATION / ENVIRONMENT Current home (please indicate) Type of home (please indicate) What is the policy regarding keeping pets where you live? (this includes the Municipal Bylaws) Garden / Yard / Erf size (m2) RENTED / OWNED FREE STANDING / COTTAGE / DUPLEX / SIMPLEX / APARTMENT Please list the duration of your stay lived in your previous 3 homes (including your current home.) Home Duration Page 2
Children & your home I have children. Ages: Children visit my home Ages: Children rarely visit your home List all the adults in your home including the domestic helper and gardener Name Relationship to you How does this person get along with the pets in your home? Your dog experience: First Time dog owner Have had one or two dogs Have had many dogs Have attended dog-training classes. Name of school / trainer: Volunteer at a Shelter How often: DOG BREED(S) & PREFERENCES Breed(s) of dogs I would like to adopt Breed(s) of dogs I prefer to not have Please tick the relevant boxes below Age of dog I prefer to adopt 2-4 months (like a toddler) Senior or special needs. Please specify 4-12 months (like a child/teenager) Gender of dog Female Male No preference 1-3 years (young adult) 3+ years (sensible adult) No preference Size of dog Tiny / very small Small Medium Large Giant Coat type Short Medium Long Curly No preference Page 3
Which behaviour(s) do you desire or could you accept: Very active (Take the dog with you for a jog every morning) Not very active (a couch potato) Calm/Gentle/Well mannered/accepts strange dogs and people happily Reserved/Shy Excitable/High Energy Confident Playful Pushy/Tests the boundaries Protective of family/home Clingy/Dependent A dog that loves cuddles An independent dog Other My dog(s) will be: Outside / Garage only, day and night. Inside only / most of the time Outside during the day, sleep inside at nights Uses dog door access to inside / outside at all times Allowed inside the house but sleeps outside at night Is there anything else you would like us to know about the type of dog you are looking for? Page 4
PETS LIVING WITH YOU PRESENT (and PAST) (Please list all in the past 10 Years) Pet s Name Age Gender Species & Breed Sterilized? If not, please explain Do you still have this pet? IF NOT, please explain Is the pet kept inside or outside? How long have you had this pet? How did you acquire the pet? Is the pet s vaccinations up to date? Date of last vaccination How well does this pet get along with STRANGE dogs and other animals? Has this dog been to Puppy Socialising classes? For how long? Has this dog been to Basic Obedience Training classes? For how long? HAVE YOU EVER HAD OF PARVO ON YOUR PROPERTY: IF YES, PLEASE GIVE DETAILS: Page 5
Have you ever handed your dog in to a Shelter for rehoming? Have you ever had a pet euthanized? Will you current pets accept and adjust easily to a new dog in the house? Please explain. Why do you want to adopt this dog? Please tick all boxes that is relevant GENERAL INFORMATION Companion for yourself & your pet(s) Other. Please explain Does any member of your household have an allergy to dogs? Is someone home during the day? If YES, who? If YES, please explain. If YES, please explain. How many hours each day will the dog be without human companionship? Please explain. Are you aware of dogs being poisoned in your area? Even if there are no incidents how will you prevent your dogs from being poisoned? Is your property completely walled / fenced? Please describe type and height of walls / fencing Do you have electric fencing? Type and height of access gate/s Breeding Hunting Watch / guard dog Do you allow your pets inside your house? Do you have a doggy door? If yes, where? Are there areas in the house that are off limits for your pets? If yes, please explain. Are there times when the dog(s) will be tethered (tied up)? If YES, please explain why & for how long. Are there stairs that lead to your home or inside your house? If YES, how many? Will the dog spend any time in the garage? If YES, please explain. Do you have a pool? If YES, is there a fence around the pool / pool cover? Is your property double gated? (Restricted access to driveway / road) Can your dog(s) be seen from the street? What kind of training methods are you familiar / comfortable with Page 6
A shelter dog might not be house trained. How will you teach the dog to use the outside facilities? Please tick the relevant box(es) Call the dog when you come across a soiled area, point the area out to the dog and scold/punish him When you catch the dog in the act you distract/tell him off and take him outside where you praise him enthusiastically if he urinates/defecates there When you find a soiled area you ignore it Take the dog outside regularly to encourage him to urinate and/or defecate outside. Will you keep the dog up-to-date on vaccinations? How often will you take the dog for a walk and for how long or how far? Will you take the dog to a park? How often? What type and brand of food do you feed your dog? Type Brand Do you leave the food out all day or do you have set feeding times? Where will the dog spend most of his / her time during the day? Where will the dog sleep at night? If you drive a bakkie / LDV and the back does not have a cover, would you allow the dog to ride in the back? If you go away for a few days, or on a vacation, who will take care of the dog? Do you have any plans to move house / emigrate? If you move / emigrate, will you take the dog with you? Are you willing to take responsibility for this dog for the next 10 to 15 years? If NOT, please explain. Have you ever applied to DogtownSA or another shelter in the past to adopt an animal? If YES, when? Have you ever surrendered animals to DogtownSA or another shelter? If YES, please explain: Are you willing to have a representative of DogtownSA come to see where the dog will be living? If NO, please explain. What provisions will you make for the dog should you become unable to care for him/her? Have you ever bred with any of your current / previous dog(s)? Have any of your pets gone missing before? If YES please give details. Page 7
Name of Veterinary Practice Area/suburb the practice is based in Telephone number/s ABOUT YOUR CURRENT VET REFERENCES Boarding Kennel (if applicable) Name Telephone no Groomer / doggy parlour (if applicable) Name Telephone no Trainer (if applicable) Name E-mail Telephone no A family member / spouse / person living with you (if applicable) Name Relationship Telephone no E-mail References of friends or family members NOT living with you 1. Name Telephone no Relationship E-mail 2. Name Telephone no Relationship E-mail Thank you for choosing to adopt :) Page 8 You will be notified via email once we have received your application. Applications may take up to 5 working days to be processed.