UKBTR Adoption Application

Name of dog applying for *	Bella (Dog - D2024053)
Applicant's First Name *
Applicant's Last Name *
Date of Birth of Applicant
Address *
City *
County
Postcode *
Phone Number * Please do not add any spaces to the phone number field
Email Address * Please enter correctly as this is the main way we will contact you
Names and Ages of ALL people living at the address
Names, ages and frequency of any visting children
Is your home rented? *	NoYes
Please select your current residence type.	House Bungalow Apartment/Flat
Does your landlord and lease allow pets?	Yes No Unsure
Do you have access to a Garden? *	NoYes
What size is your garden?
Is the Garden fenced/walled all round? What height are the fences/walls?
Do you own other pets at the current time?	NoYes
Please list their names, breeds, and ages.
Are all of your pets spayed/neutered?	NoYes
Are your pets up to date on their vaccinations?	NoYes
Veterinarian's Name If you have never owned a pet please tell us where you would go.
Veterinarian's Address, City, Postcode
Veterinarian's Phone Number
How do you feel about having pets spayed/neutered?	Agree Disagree
If you have pets, how do you think they will they adjust to a new pet in the house?
Is everyone in your household aware that you are planning to adopt a pet?	NoYes
Employment Status	Full-Time Part-Time Retired Work from Home Stay at Home Parent Student Unemployed Other
How long is your commute?
On average, how many hours per day will the dog be left alone?
Do you have exerpience/knowledge of Boston Terriers?
Please tell us about your experience with dogs in general
Please tell us why you have chosen this dog to adopt
Have you ever had to rehome a previous dog/pet? *	NoYes
Please tell us why the pet was rehomed?
Do you have experience of dog behaviour issues? *	NoYes
Please provide details and how you dealt with these
Do you have any experience of dog health issues? *	NoYes
Please provide details of dog health issues and how you have dealt with these.
We strongly advice getting Dogs Insured, do you agree?	NoYes
How would you fund any Medical/Surgical Procedures?
Where would the dog sleep?
How would you handle a dog not being housetrained?
How would you handle destructive behaviour?
Are you willing and able to exercise the dog on a regular basis?	NoYes
If yes, what is the method of exercise?
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 would you do with the dog when you go on holiday or have an event planned?
Are you willing to take responsibility for this animal for the rest of its life?	NoYes
If no, please explain:
For what reason(s) would you consider returning/giving up the animal?
Will you allow us to perform home checks?	NoYes
How did you find out about us?	Internet Search Family/Friend Volunteer Facebook/Instagram
Are you happy for us to follow you on Facebook?	NoYes
Please confirm your Facebook Name
Are you happy for us to follow you on Instagram?
Please provide your Instagram UserName
I have read the foregoing and certify that the answers I have given are complete, true and not misleading in any way. I am authorising you to contact landlords and veterinarians. You are also aware that we cannot guarantee the health and temperament of the animal.	NoYes
Signature *	Clear
Date *

PRIVACY INFORMATION

 

This privacy information sets out how UK Boston Terrier Rescue (UKBTR) uses and protects any personal information that you provide us. 

UKBTR is committed to ensuring that your privacy is protected. Should we ask you to provide certain information by which you can be identified when
using our rescue services, you can be assured that it will only be used in accordance with this privacy statement

Security - We are committed to ensuring that your information is secure. In order to prevent unauthorised access or disclosure, we have put in place
highly secure electronic systems and managerial procedures to safeguard and secure the information we collect. 

Controlling your personal information -  We will not distribute, sell or lease your personal information to third parties unless we have your explicit permission or are required by law to do so. 

You may request details of personal information which we hold about you under the General Data Protection Regulation (GDPR).  If you would like
a copy of the information held on you or request we delete your information or would like a full copy of our Privacy Information Policy, please contact Beth Bartlett
at info@ukbostonterrierrescue.co.uk.co.uk.