Are you applying for a specific animal? If so, who?
If no, what type of animal are you looking to adopt? *
Dog
Cat
Applicant Forename *
Applicant Surname *
Date of Birth
Address *
Postcode *
Mobile Telephone *
Home Telephone
Alternate Number
Email *
Where did you hear about us?
Web Search
Facebook
Pets4Homes
Friends & Family
Other
Property Type *
Detached
Semi-Detached
Terraced
Flat
Other
If you live in a flat, what floor are you on? And do you have a balcony?
Is your house rented or owned? *
Rented
Owned
Does your landlord permit pets?
Please note we will need written confirmation of the landlord's permission
No Yes
Do you have a garden? *
No Yes
If yes, what size is your garden?
If no, what would be the dog's main area of toiletting?
Can you describe your garden securing arrangements and the height of any fences or walls? *
What access is there to the garden? *
(i.e. is there a secure side gate or is access just through the house)
Are there any structures that the dog could jump on and use to escape? *
Do you intend to move house in the next 12 months? *
No Yes
How many adults live in your home? *
How many children live in your home? *
What are the ages of the children living at the property?
Do the children have any animal experience?
Do any children under the age of 6yrs visit regularly? If yes, how often, and do they have animal experience?
Are there any current resident pets? *
No Yes
What is the type / age / sex / breed / temperament of all pets
If you have pets other than dogs, have they been around dogs before?
What are the working arrangements of all adults in the home? *
How long will the animal be left alone in a day?
Where will the animal be left when alone?
What arrangements will you have in place for their arrival?
(e.g. taking time off work, creating safe spaces for existing pets)
Have you owned a pet before, and do you have any rescue experience? *
Is anyone in your home banned from keeping pets? *
No Yes
Have you ever given up or re-homed a pet before? *
If yes, please explain in detail why this was
Does anyone in the home have any medical conditions that may affect the welfare and care of the pet? (i.e. disability, allergy, other)
If you are taken ill, who would look after them? *
Do you have a vet or one in mind? *
If yes, please give name and address
Please describe to us what you are looking for in your new rescue animal. *
Are you able to consider any animal with behaviour or medical problems?
No Yes
Are you prepared to take on the responsibility of a rescue, and do you feel you can work with them and give them the time and patience they needs to adjust? *
Our animals have only ever lived on the streets or in shelter so may come with some issues such as toilet training, lack of experience with humans, not used to a lead/harness, etc. regardless of their age. Leaving everything they have known behind, and embarking on such a long and traumatic journey means lots may need time and patience to help them settle and begin to trust. It can take days, weeks, or even months, before you see their real character and for them to feel safe and comfortable in their new environment
No Yes
Why have you decided a rescue animal from us is right for you and your family? *
Is there any other information you feel would be relevant to your application?
By what method do you agree to be contacted by Penny's Ark in relation to your application and any subsequent adoption proceedings? *
All personal information supplied by you on this form will be processed by Penny’s Ark (charity number 1205298) and whose privacy policy is available on request.
Declined
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Post
SMS
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