Perfect Match Form DOGS

APPLICATION TO ADOPT A DOG / PUPPY

Great news; you want to adopt or foster a dog or puppy from us.
We just need to get a few details from you so we can find the perfect animal for you.
Please answer honestly so we find the right match!

If you are interested in a specific dog, please tell us their name
Or describe what sort of dog/breed you are looking for
Title	Mr Mrs Miss Ms Other
First name *
Surname *
Address *
Town
Postcode *
County
Best telephone number to contact you on *
Email address *
WHERE DID YOU HEAR ABOUT US?
Please advise how you heard about RSPCA Worcester & Mid-Worcs Branch	Facebook/social media Already aware of centre/branch Website Word of mouth Just passing NCC/RSPCA enquiries Other
Adopting or fostering *	Adopting Fostering
Size of dog *	Small (e.g. terrier) Medium (e.g. Staffie) Large (e.g. Labrador) Any
Age of dog *	Puppy Less than 2 years 2-5 years 5-8 years 8+ years Any
Gender of dog *	Male Female Either
Do you own or rent your home? *	Own Rent
If you rent, have you got written permission from your landlord?	NoYes
What type of home do you have? *	House Bungalow Flat Ground floor flat Mobile Home Other
Do you have a garden? *	Yes No Communal
Is the garden secure from escape? *	Yes No Not sure
Please provide details of provisions to prevent escape (e.g. fencing, won't be let out unsupervised): *
A LITTLE BIT ABOUT YOUR FAMILY:
Including yourself, how many adults live in your home? *	1 2 3 4 5+
How many children live in your home? *	0 1 2 3 4 5 6+
If children live in your home, please state their age(s)
Any visiting children? *	NoYes
If yes, please state children's age(s)
Frequency of visits	Daily Weekly Monthly Annually
Do you own other dogs? *	NoYes
If yes, please state age and gender of dog(s)
Are they neutered?	NoYes
Are they vaccinated?	NoYes
Do you own other pets? *	No Cats Rabbits Rodents Pet birds Other
Do you have any visiting animals (e.g. family/friends' cats and dogs)? If so, please give details
A LITTLE BIT ABOUT YOUR LIFESTYLE:
How much daily exercise do you expect to give the dog (No of hours weekdays)? *
(No of hours weekends)? *
How active are you? *	Very Reasonably Not very
How long do you expect to leave the dog alone on a regular basis? *
Is this:	Daytime Evening Night time
How often?
Are you planning any of the following? *	Moving house Holiday in the next few weeks None of the above
YOUR IDEAL DOG WOULD:
Be good with cats *	Very important Quite important Not important
Like other dogs *	Very important Quite important Not important
Be good with livestock *	Very important Quite important Not important
Be comfortable around children *	Very important Quite important Not important
Like strangers *	Very important Quite important Not important
Be housetrained *	Very important Quite important Not important
Enjoy being handled/petted *	Very important Quite important Not important
Like travelling in the car *	Very important Quite important Not important
YOUR EXPERIENCE:
I need a dog that has already been trained *	NoYes
I am a first time dog owner *	NoYes
I have trained pet dogs before *	NoYes
I would enjoy training a dog *	NoYes
I am an experienced owner and could train a difficult dog *	NoYes
Signature *	Clear
Date *
We'd love to keep you updated about our fundraising activities and ways in which you can support us to help animals. Tell us how you would like to hear from us	Post Telephone Email SMS

All personal information supplied by you on this application form will be processed by the Royal
Society for the Prevention of Cruelty to Animals whose privacy policy is available and published
at www.rspca.org.uk/privacy or on request by calling Supporter Services on 0300 123 0346.
This applies whether the information is supplied directly to national RSPCA (charity number 219099),
as data controller, or is shared with us by an RSPCA Branch (RSPCA Worcester is a separately
registered charity no 205930) as a joint data controller. The term "RSPCA" will refer to both data controllers.

WHILST EVERY CARE IS TAKEN TO FIND THE RIGHT DOG FOR YOU, WE CANNOT GUARANTEE BEHAVIOUR