Date form filled in
Second Applicant Name (partner, spouse, etc)
Door Number & Street Address
Other (please add in next field)
City of Hamilton
Town of St George
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).
I am interested in
A single dog
More than two
If you are applying concerning a specific animal, please let us know its name, details etc, and where you saw the animal listed.
What size dog?
What age dog are you looking for? You can pick more than one if you need to. Please note: It is an urban 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, and linked to breed, and based on how much time you will be willing to put into training, rather than just age
Under 3 months
Under 2 years
Older than 2 years
Not fussed as I am interested in their personality mainly
Any specific breed? (Please note we are a rescue shelter so the range of breeds and frequency of breeds occurring is low)
Do you already have fencing suitable for a restricted breed
Yes(suitable for Non-restricted Breed)
Yes (suitable for restricted breed as fencing is 4 -6Ft in height)
Male or female?
Do not mind
Is the property where the dog will live located on a busy road?
What provision do you have planned to exercise and stimulate the dog?
Will be inside only
will exercise on lead
A bit about your family and home. Please select from the drop down, any that apply - more than one reply will be needed and the ones you select will appear below the box (hopefully!). You can comment further in the notes at the end. 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
Your existing pets are.....(choose all that apply)
Fully up to date with their vaccinations
Haven't been vaccinated since being a kitten/puppy
Fully wormed and de-flead currently
Housed mainly indoors
How long would the dog be left? More than one response can be selected.
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 select any statement that applies to you. You can pick more than one.
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 litter 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
Which vet do you currently use for existing pets?
No existing pets
Don't have a vet.
Declaration: 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
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?
I am 18 years or older
Do you understand that falsification of the above information may result in an adoption being declined or confiscation of the adopted pet.
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 photographed. At present, the software does not allow you to attach documents, PDFs or email to this form, but you can email these (or forward them) to firstname.lastname@example.org - please mention in the email your name and address so we can link them to this application. Thank you.
You can sign electronically, either with your finger (on a touchscreen) or the mouse. If the signature comes out wrong, or indeed very wrong, you'll be asked to re-sign it later. *