Dog Adoption Form

Perfect Match
Application to adopt a dog

Thank you for wanting to adopt a dog from us. We just need to get a few details so that we can find a suitable animal for you. Please answer as honestly as you can so that we find the best match.

ABOUT YOU
Title
Surname
First Name
Address
Postcode
Email
Telephone

YOU ARE INTERESTED IN:

Size of dog:
AnySmall ( e.g. Terrier)Medium ( e.g. Staffie)Large (e.g. Labrador)
Age of dog:
AnyPuppyLess than 2 years2-5 years5-8 years8 years +
Gender of dog:
EitherMaleFemale
Any further details on what type of dog you are looking for:

A LITTLE BIT ABOUT YOUR HOME
Do you live in a flat ?
NoYes
Do you own or rent your property:
OwnRent
If you rent, have you got written permission from your landlord?
N/AYesNo

Do you have a garden ?
YesNoCommunal
Is the garden secure from escape?
YesNoNot SureN/A

A LITTLE BIT ABOUT YOUR FAMILY
Who lives at home ?
Number of Adults
Number of Children
Children Ages

Do you own other dogs?
NoYes
If Yes, please state gender
N/AMaleFemale
Are they neutered?
N/AYesNo
Have they been vaccinated within the last year
N/AYesNo
Do you own other pets ?
NoCatsRodentsPet BirdsOther
If "Other" then please state

Do you have any visiting animals (e.g. family/friends' cats and dogs)? If so , please give details

A LITTLE BIT ABOUT YOUR LIFESTYLE
How active are you ?
VeryReasonablyNot very
How many hours do you expect to leave the dog alone on a regular basis in the long term? (once you return to work and other activities post Covid-19)

Will this be
DaytimeEveningNight time
How often?

Are you planning any of the following?
Moving House NoYes
Holiday in the next few weeks NoYes

YOUR IDEAL DOG WOULD:
Be good with cats:
Very ImportantQuite importantNot important
Like other dogs :

Be good with livestock:
Very ImportantQuite importantNot important
Like strangers:

Be housetrained
Very ImportantQuite importantNot important
Enjoy being picked up/petted
Very ImportantQuite importantNot important
Like travelling in the car:

YOUR EXPERIENCE
I need a dog that has already been trained.
NoYes
I am a first time dog owner:
NoYes
I have trained pets before
NoYes
I would enjoy training a dog
NoYes
I am an experienced owner and could train a difficult dog:
NoYes

The safety of our staff and visitors is RSPCA Radcliffe Animal Centre's top priority.
To prevent the spread of COVID-19 and reduce the potential risk of exposure to our staff and visitors, we are
conducting a simple screening questionnaire. Your participation is important to help us take precautionary measures to protect you and everyone on this site.
Thank you for your time.

Have you, or any other visitors, had close contact with or cared for someone diagnosed with COVID-19 within the last
14 days?
NoYes

Have you, or any other visitors, experienced any cold or flu-like symptoms in the last 14 days (to include fever, cough,
sore throat, respiratory illness, difficulty breathing)?
NoYes

Is anyone in your household shielding or been identified as clinically vulnerable?
NoYes

All personal information supplied by you on this application form will be processed by the Royal Society for the Prevention 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 number 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.

Whilst every care is taken to find the right dog for you, we cannot guarantee the future health and behaviour of any animal.

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