Perfect Match for Dogs *
Dog Name(s)
A little about your dog preferences...
Size of Dog
Small (e.g. terrier)
Medium (e.g. Staffie)
Large (e.g. Labrador)
Any
Age of Dog
Puppy
Less than 2 years
2-5 years
5-8 years
8 years plus
Any
Sex
Any
Male
Female
Why are you interested in adopting this dog?
*
Would you be interested in us suggesting other potential matches or are you only interested in a specific dog?
Just this Dog
I would consider other dogs
Your ideal dog would...
Be good with cats
Very Important
Quite Important
Not Important
Like other dogs
Very Important
Quite Important
Not Important
Be good with Livestock
Very Important
Quite Important
Not Important
Be good with children
Very Important
Quite Important
Not Important
Like Strangers
Very Important
Quite Important
Not Important
Be housetrained
Very Important
Quite Important
Not Important
Enjoy being petted
Very Important
Quite Important
Not Important
Like travelling in the car
Very Important
Quite Important
Not Important
Now a little about your home
Do you own or rent your property?
Own
Rent
If renting - do you have permission from your landlord?
No
Yes
Do you have a garden?
Yes
No
Communal
Is the garden secure from escape?
Yes
No
Not Sure
Please provide details of the provisions you have in place to prevent escape?
Please briefly describe a typical day in your household and how a dog might fit into it?
A little about your family...
How many adults live in your home?
1
2
3
4
5+
How many children are at home?
0
1
2
3
4
5+
Please detail the ages of your children
Are there visiting children?
No
Yes
Please detail the ages of any visiting children, and how often they visit
How long do you expect to leave the dog alone on a regular basis?
Never
Hardly ever
1-2 hours
2-4 hours
4-6 hours
6-8 hours
8+ hours
If you are out for long periods, what provisions will you have in place to ensure the dog is not left for too long?
How much exercise will you be able to give a dog on a typical weekday?
How much exercise will you be able to give a dog on a typical weekend day?
What hobbies or activities would like to or envisage including a dog in?
A little about your other animals...
Do you have other dogs?
No
Yes
If yes, please state gender?
Are they neutered?
No
Yes
Are they vaccinated?
No
Yes
Do you own other animals? If yes, please detail
Do you have visiting animals? If so, please detail...
Is there anything else you would like to tell us?
Your Contact Details
Surname
*
Firstname
*
Title
*
Mr
Mrs
Miss
Dr
Prof
Other
Other
Email Address
Address
*
Town
*
County
*
Postcode
*
Home Telephone
Mobile Number
Primary No
*
Home Telephone
Mobile Telephone
What is the best time to contact you?
Where did you hear about us?
Advertisement
Already Aware of Centre
Referred By Owner
Website
Referred by other establishment
Just Passing
Word of Mouth
NCC/RSPCA enquiries
Facebook/Social Media
Shop
Newspaper/Magazine
Other (please state where)
Other
Are you interested in Adopting or Fostering?
*
Adopting
Fostering
Either
Are you on holidays or moving house in the next 6 weeks?
*
No
Yes
Confirmation
Signature
Clear
We'd love to keep in contact with you!
We’d love for you to become part of our community and to be able to keep you up to date about our news, tips and events. Tell us how you would like to hear from us.
Which methods would you be happy with us contacting you through. You can select more than one.
Declined
Email
Post
SMS
Phone
All personal information supplied by you on this application form will be processed by the Royal Society for the Protection of Cruelty to Animals whose privacy policy is available and published at: www.rspca.org.uk/privacy or on request by calling Supporter Services on 0300 123 0346. This applies whether the information is supplied directly to the national RSPCA (charity 219099), as data controller, or is shared with us by an RSPCA Branch (a separately registered charity) as a joint data controller. The term "RSPCA" will refer to both data controllers.
End of Form