Adoptadane Expression of Interest

Filling out this application does not guarantee that the dog you choose will be available to you. We carefully review each application and place dogs based on a variety of criteria and ultimately, will always act in the best interest of the dog.

Animal you are interested in adopting
Second Choice: Animal you are interested in adopting
Applicant's First Name *
Applicant's Last Name *
Street Address *
City *
State * Note that Adoptadane does not adopt dogs to residences outside of the state of Queensland	QLD NSW VIC SA NT ACT WA TAS
Postcode *
Phone Number * Please use the following format 0404 101 101
Email Address * Please enter correctly as this is the main way we will contact you
Mobile Phone Number *
How did you find out about us?	Savourlife Adopt A Dog Petrescue Internet Search Family/Friend Staff/Volunteer Facebook/Twitter Other
Do you own other pets at the current time?	NoYes
If yes, please list their names, breeds, gender and ages.
Are all of your pets spayed/neutered/fixed? *	Yes No N/A
How many pets have you owned in the last 5-10 years?
What happened to them?
Are your pets current on their vaccinations?	Yes no n/a
Have you ever turned your dog or cat into a shelter?	NoYes
If yes, please explain?
Have you ever had a pet euthanized?	NoYes
If yes, please explain:
How do you feel about having pets spayed/neutered? *	Agree Disagree Not Sure
Are you familiar with heartworm and heartworm prevention?	NoYes
Please describe in detail the pet you are looking for.
Do you own or rent your home?	Own Rent Someone else owns the Home Someone else rents the Home
If you rent, does your landlord and lease allow pets? *	Yes No Unsure N/A
Including yourself, how many people live in your household?
Please list the ages & relationship of those who live in your home.
Is everyone in your household aware that you are planning to adopt a pet?	Yes No N/A
On average, how many hours per day will your pet be left alone?
Will this pet be predominantly living inside, outside, or both?	Inside Outside Both
Please provide a description of this pet's living conditions.
Do you have a completely fenced-in yard? If so, what kind of fence?	Wood Chain Link Electric Plastic Iron Other Other (I do not have a fenced yard)
How high is your fence?	3ft 4ft 5ft 6ft 6ft+
If you answered "other" above, please explain:
If you do not have a fenced yard, how will you let the animal out?
Are there times when the animal will be tied/chained up? *	Yes No N/A
If yes, when will they be tied/chained up?
Where will the animal sleep?	In bed with me In bed with my child In a dog / cat bed In a kennel / crate Wherever he or she likes Outside Other
If you answered "other" above, please explain:
Will you keep the animal up-to-date on vaccinations and heartworm preventative?	NoYes
Are you willing and able to exercise the dog on a regular basis?	Yes No N/A
If yes, what is the method of exercise?	Walking Running Dog Park / Dog Run Other
If you answered "other" above, please explain:
If yes, please explain:
What arrangements will you make for the care of your pets in case of an emergency?	Leave with family/friend Boarding Pet Sitter Take with me/us Other
If you answered "other" above, please explain:
What will you do with the animal when you go on vacation?	Leave with family/friend Boarding Pet sitter Take with me/us Other
If you answered "other" above, please explain:
For what reason(s) would you consider returning/giving up the animal?
What would you do with your animal if you had to move?	Take him / her with me Give to family or friend Return to shelter Other
If you answered "other" above, please explain:
Are you willing to take responsibility for this animal for the next 5-10 years?	NoYes
If no, please explain:
Will you allow us to perform home checks? *	NoYes
I have read the foregoing and certify that the answers I have given are complete, true and not misleading in any way. By selecting Yes you are also acknowledging that while we perform all of the checks and tests that we are reasonably able, we cannot guarantee the health and temperament of the animal. *	Yes No
I confirm I have read the dogs profile correctly and meet all the criteria outlined. I understand successful applicants will be contacted via email. If I am not contacted I understand that I was not successful. *	NoYes

Please note: This application is forwarded to several Adoptadane Rescue Inc. volunteers who respond in a coordinated effort. Your personal information will never be shared, but you may receive responses from emails that don’t contain @adoptadane.com.au, as volunteers use their personal email addresses.