Are you 18 years of age or older? *
No Yes
First Name(s) *
Last name *
Title
Mr
Mrs
Ms
Mx
Other
Email Address *
Door Number & Street Address *
Address Notes (unit #/house colour/landmarks)
Parish *
Devonshire
Hamilton
Paget
Pembroke
Saint 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 you 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)
What type of animal are you looking to adopt? *
Bird
Cat
Chicken
Chinchilla
Cockatiel
Cow
Dog
Dove
Duck
Fish
Gerbil
Goat
Goldfish
Goose
Guinea Pig
Hamster
Horse
Mouse
Multi Species
Octopus
Other
Parrot
Pig
Pony
Rabbit
Rat
Sheep
Terrapin
Tortoise
Unknown
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 rabbit to live alone
A pair
More than two
A rabbit to pair up with my existing one
Hamster
A single Guinea Pig to live alone
A pair of Guinea Pigs
A Guinea Pig to pair up with my existing one
Parrot or other bird
What age small animal are you looking for? *
Any age
Very Young
Young
Older
Male or female?
Any
Female
Male
The animal will live in: *
House only
House with access to garden
Hutch only
Hutch and run
Enclosed area in yard
Indoor cage
Aviary
(Rabbits only) Please attach a picture of the enclosure where the bunny will live, or if you don't have one yet, of where it will be positioned/located *
Is your existing rabbit/guinea pig neutered or spayed?
Yes
No
Don't know
Don't have an existing rabbit/guinea pig.
Which vet do you currently use for existing pets? *
Ettrick
Endsmeet
Cedar Tree
BVS
VetSmith
No existing pets
Don't have a vet.
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 cat(s)
We have dog(s)
We have visiting dogs or cats into the house
We have other rabbits/small animals/birds
We have no existing pet(s)
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 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
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 rabbit owner
I am a first time rabbit owner
I am a more experienced guinea pig owner
I am a first time guinea pig 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 *