I am 18 years or older *
|Must be 18 years or older to Adopt
No Yes
First name *
Last name *
Title
Email Address *
Door Number & Street Address *
Address Notes (unit #/house colour/landmarks)
Parish *
Devonshire
Hamilton
Paget
Pembroke
St George's
Sandys
Smiths
Southampton
Warwick
City of Hamilton
Town of St George
Postal Code *
Do you own or rent? *
Own (if you own a Condo your committee will need to confirm it's ok to have this type of pet).
Rent (if rent, your landlord will need to confirm it's okay to have this type of pet).
Home Phone
Work/Other phone
Mobile Phone *
Second Applicant Name (partner, spouse, etc)
If you are applying concerning a specific animal, please let us know its name, details etc, and where you saw the animal listed.
I am interested in (More than one response can be selected) *
A single dog
Restricted breed
Non-restricted breed
More than two
Do you have a enclosed area? (Please note: any fencing for restricted breeds will need to be approved by the Animal Wardens before the adoption can be finalised)
No
Yes (suitable for non-restricted breed)
Yes (suitable for restricted breed as fencing is 4-6ft in height)
Don't know
What size dog are you interested in? *
Any size
Small
Medium
Large
Very Large
What age dog are you looking for? (Please note: It is a myth that a puppy will always be more suitable than an adult dog for various situations. Temperament is inherited, learned in early life before weaning, linked to breed, and based on how much time you will be willing to put into training, rather than just age) *
Any age
Puppy (0-1yr)
Young Dog (1-4yrs)
Older dog (5+ years)
Male or female? *
Any
Female
Male
Do you have an existing dog in the house? *
No Yes
Do you have an existing cat in the house? *
No Yes
Your existing pets are.....(choose all that apply) *
Fully up to date with their vaccinations
Haven't been vaccinated since being a kitten/puppy
Neutered
Not neutered
Fully wormed and de-flead currently
Licenced
Housed mainly indoors
I/We do not have any other pets
Which vet do you currently use for existing pets? *
Ettrick
Endsmeet
Cedar Tree
BVS
VetSmith
No existing pets
Don't have a vet.
Fencing options
Enclosed perimeter
Enclosed porch
Enclosed pool deck
Kennel
Other enclosed area 100sq min
What provision do you have planned to exercise and stimulate the dog? (More than one response can be selected) *
Will be inside only
Communal garden
Own garden
Will exercise on lead
Training and/or regular toy play
How long would the dog be left? (Please select any/all that apply) Most dogs are able to be left for a while, but some need more constant attention and reassurance. The purpose of this question is for us to avoid introducing you to an animal for adoption which would be unsuitable. *
Never left
Can go to work with me
1 or 2 hours
3 or 4 hours
During the working day
Occasionally during the day into late evening
I am away a lot but use a sitter
I am away a lot but the dog would go stay at the vets or a boarding establishment.
Please let us know a bit about your family and home. (Please select any/all that apply). You can comment further in the Additional Information section. The purpose of this question is for us to avoid introducing you to an animal for adoption which would be unsuitable. *
We have young kids under 5
We have kids between 5 and 10
We have kids older than 10
We have kids visiting regularly
We have 3 or fewer adults at home
There is only me at home
We have cats
We have no cats
We have a dog
We have several dogs
We have visiting dogs or cats into the house
We have other small animals or birds in the home
Please select any statement that applies to you. (More than one response can be selected) *
It is very important that the animal is good with dogs
It is very important that the animal is good with cats
It is very important that the animal is house trained
It is very important that the animal is comfortable around children
It is very important the animal is comfortable being picked up/petted
It is very important the animal likes to play with toys
I am a first time dog owner
Being good with dogs is not that important
Being good with cats is not that important
Being good with young kids is not that important
Being picked up and petted are not that important
I am a more experienced dog owner
Additional Information (Is there anything else you would like us to know that you were not able to include above?)
Do you agree that your adopted pet will receive the needed medical attention at your own expense and you are aware of the costs of preventative, routine and emergency care? *
No Yes
Do you understand that this application does not guarantee that you are able to adopt a specific named animal, or any animal, from the SPCA? *
No Yes
Do you understand that falsification of the above information may result in an adoption being declined or confiscation of the adopted pet? *
No Yes
Photo of your driving licence, Bermuda ID card, or other Government issued ID. The application cannot proceed without this. *
If you have a written or printed note of permission from your landlord, you can attach it here if it can be sent as a .JPG file. (At present, the software does not allow you to attach documents or PDFs to this form, but you can email or forward these to info@spca.bm-you must include your name and address so we can link them to your application). Thank you.
You can sign electronically, either with your finger (on a touchscreen) or the mouse. If the signature comes out wrong, you'll be asked to re-sign it later. *
Clear
Date form filled in *