Dog Booking Form

Dog Booking Form - (if the name of the dog you are interested in is not showing, that dog is already reserved)

Name of Animal *	BRODIE (Dog - D 20243882) TILLIE (Dog - D 20233666)
Are you ready to adopt IMMEDIATELY! If not in position to adopt within 48hrs - please wait until you are before applying. *	NoYes
Earliest date can collect pet? If not within 48hrs - please DO NOT apply! *
Do you have any holidays booked this year? *	Yes No
Reason for selecting this dog? *
Title
First Name *
Last Name *
Address *
Town *
County *
PostCode *
Mobile Number *
Work Telephone
Telephone *
Email Address *
Have you been home checked by any other rescue or a previous adopter from DBARC? (If DBARC adopter, please give the name of the animal and how long ago you adopted them) *
Type of Accommodation house / flat / other *
Home owned / rented? *	Owned Rented
If rented, do you have consent to keep a dog?	Yes No
Approximate size of garden? *
Fencing - type and height, Is this fencing totally secure? *
Will dog be living in home or garden/kennel? *	Home Garden Kennel
Number of adults in household? *
Age of ALL adults *
What back up do you have if you become ill and unable to care for the dog? *
Numer of children and ages, either living in home or regularly visiting? *
Is this likely to change in future? *	Yes No Not sure
Occupation and working hours of all adults If taking dog to work – what occupation? *
Detail days & times dog will be left on own *
Details of any other animals currently resident with adopter. (Please include species, age, and for other dogs breed and gender) *
If another dog – is it neutered? *	Yes No Not sure N/A
Are these animals up to date with vaccines? (vaccine cards will be checked by homechecker) *	Yes No Not sure N/A
Are these animals used to dogs? *	N/A Yes No
Where will you be walking the dog, and how often & how long will the walks be? *
How much experience have you had of owning a dog? Please give details of previous dogs. *
Do you understand it will take weeks, sometimes months to settle a new dog in? *	Yes No
If your new dog develops any behavioural/training issues - what action would you plan to take? *
Availability for home check appointment? *
Please add any other information you think may be helpful in your application here or type no other information *
Comfortable with suggested minimum donation? *	Yes No
A DONATION AT ADOPTION IS GRATEFULLY RECEIVED and is vital to our work. It is NOT a fee for buying an animal, but is a voluntary donation to help the charity with its general animal welfare work and is NOT refundable. DBARC DOES NOT SELL ANIMALS, BUT ALLOWS APPROVED INDIVIDUALS TO ADOPT THEM. Please confirm you understand any donation given is non refundable. *	NoYes
GIFTAID DECLARATION (IF YOU ARE A UK TAXPAYER THIS MAKES YOUR DONATION WORTH 25% MORE)  ARE YOU A UK TAX PAYER?    If yes I wish the Charity to treat all the donations/subscriptions which I have made during the past 4 years, this donation and all future donations/subscriptions as Giftaid donations, until I notify you otherwise.(Please note that you must pay an amount of UK Income Tax or Capital Gains Tax equal to the tax deducted from your donations for your gift to be eligible for Giftaid and understand that if I pay less Income Tax and/or Capital Gains Tax than the amount of Gift Aid claimed on all my donations in that tax year it is my responsibility to pay any difference) *	Yes No
Your preferences about how to stay in touch (e-mail, phone, text, post, non) *	Declined Email Post SMS Phone