Date you have completed this form *
Your dogs name *
Upload photo of your dog *
Please upload a recent photo of your dog. You may be asked to provide more photos of your dog to publish on social media or to supply to potential adopters.
Date of Birth of Dog
Age *
Has the dog been desexed?
If so you will be required to upload their desexing certificate or their current council registration to show they are desexed. If you don't have a certificate you may be able to get a copy from the vet who performed the desexing or a copy of the council registration from Council or PetRegistry.
No Yes
Upload an image (not a file) of the Desexing Certificate or proof of desexing ie. current council registration
Microchip Number
Sex *
Male
Female
Are you the registered owner of the dog? *
No Yes
Species *
Cat
Dog
Breed *
Affenpinscher
Afghan Hound
African Grey
Airedale Terrier
Akbash
Akita
Alaskan Malamute
American Bulldog
American Eskimo Dog
American Staffordshire Terrier
American Staffordshire Terrier cross
American Water Spaniel
Anatolian Shepherd
Appenzell Mountain Dog
Australian Cattle Dog
Australian Cattle Dog Cross
Australian Kelpie
Australian Shepherd
Australian Terrier
Basenji
Basset Hound
Beagle
Bearded Collie
Beauceron
Bedlington Terrier
Belgian Hare
Belgian Shepherd Dog Sheepdog
Belgian Shepherd Laekenois
Belgian Shepherd Malinois
Belgian Shepherd Tervuren
Bernese Mountain Dog
Bichon Frise
Black and Tan Coonhound
Black Labrador Retriever
Black Mouth Cur
Bloodhound
Bluetick Coonhound
Border Collie
Border Terrier
Borzoi
Boston Terrier
Bouvier des Flanders
Boxer
Boykin Spaniel
Briard
Brittany Spaniel
Brussels Griffon
Budgie/Budgerigar
Bullmastiff
Bull Terrier
Bull Terrier x Aust. Cattle Dog
Burmilla
Cairn Terrier
Calico
Californian
Canaan Dog
Cane Corso
Carolina Dog
Catahoula Leopard Dog
Cattle Dog
Cavalier King Charles Spaniel
Champagne D'Argent
Chartreux
Checkered Giant
Chesapeake Bay Retriever
Chicken
Chihuahua
Chinchilla
Chinchilla
Chinchilla
Chinese Crested Dog
Chinese Foo Dog
Chocolate Labrador Retriever
Chow Chow
Cinnamon
Clumber Spaniel
Cockapoo
Cocker Spaniel
Collie
Conure
Coonhound
Corgi
Cornish Rex
Coton de Tulear
Cow
Creme D'Argent
Cymric
Dachshund
Dalmatian
Dandi Dinmont Terrier
Doberman Pinscher
Dogo Argentino
Dogue de Bordeaux
Domestic Long Hair
Domestic Medium Hair
Domestic Short Hair
Draft
Dutch
Dutch Shepherd
English Bulldog
English Cocker Spaniel
English Coonhound
English Lop
English Pointer
English Setter
English Shepherd
English Spot
English Springer Spaniel
English Toy Spaniel
Entlebucher
Eskimo Dog
Exotic Shorthair
Extra-Toes Cat (Hemingway Polydactyl)
Ferret
Field Spaniel
Fila Brasileiro
Finch
Finnish Lapphund
Finnish Spitz
Flat-coated Retriever
Florida White
Foxhound
Fox Terrier
French Bulldog
Gaited
German Pinscher
German Shepherd
German Shepherd Cross
German Shepherd x Rottweiler
German Shorthaired Pointer
German Wirehaired Pointer
Glen of Imaal Terrier
Golden Retriever
Gordon Setter
Grade
Great Dane
Great Dane Cross
Great Dane x Bull Arab
Greater Swiss Mountain Dog
Great Pyrenees
Greyhound
Guinea fowl
Harlequin
Havana
Havana
Havanese
Himalayan
Himalayan
Hotot
Hound
Hovawart
Husky
Ibizan Hound
Illyrian Sheepdog
Irish Setter
Irish Terrier
Irish Water Spaniel
Irish Wolfhound
Italian Greyhound
Italian Spinone
Jack Russell Terrier
Japanese Bobtail
Japanese Chin
Javanese
Jersey Wooly
Jindo
Kai Dog
Kakariki
Karelian Bear Dog
Keeshond
Kelpie cross
Kerry Blue Terrier
Kishu
Korat
Kuvasz
Kyi Leo
Labrador Retriever
Labrador Retriever Cross
Lakeland Terrier
Lancashire Heeler
Leonberger
Lhasa Apso
Lilac
Lowchen
Maltese
Manchester Terrier
Manx
Maremma Sheepdog
Mastiff
McNab
Miniature Pinscher
Mini-Lop
Mini Rex
Missouri Foxtrotter
Mixed Breed
Morgan
Mountain Cur
Mountain Dog
Munchkin
Munsterlander
Mustang
Mynah
Neapolitan Mastiff
Newfoundland Dog
New Guinea Singing Dog
Norfolk Terrier
Norwegian Buhund
Norwegian Elkhound
Norwegian Lundehund
Norwich Terrier
Nova Scotia Duck-Tolling Retriever
Old English Sheepdog
Otterhound
Papillon
Patterdale Terrier (Fell Terrier)
Pekingese
Peruvian Inca Orchid
Petit Basset Griffon Vendeen
Pharaoh Hound
Pit Bull Terrier
Pixie-Bob
Plott Hound
Poicephalus/Senegal
Pointer
Polish Lowland Sheepdog
Pomeranian
Poodle
Portugese Podengo
Portuguese Water Dog
Pot Bellied
Prairie Dog
Presa Canario
Pug
Puli
Pumi
Quaker Parakeet
Quarterhorse
Ragamuffin
Ragdoll
Rat Terrier
Redbone Coonhound
Retriever
Rhodesian Ridgeback
Rhodesian Ridgeback Cross
Rosella
Rottweiler
Rottweiler Cross
Russian Blue
Saddlebred
Saint Bernard St. Bernard
Saluki
Samoyed
Satin
Schipperke
Schnauzer
Scottish Deerhound
Scottish Terrier Scottie
Sealyham Terrier
Setter
Shar Pei
Sheep Dog
Shepherd
Shetland Sheepdog Sheltie
Shiba Inu
Shih Tzu
Siamese
Siberian
Siberian Husky
Silky Terrier
Silver
Silver Fox
Silver Marten
Skye Terrier
Sloughi
Smooth Fox Terrier
South Russian Ovcharka
Spaniel
Sphynx (hairless cat)
Spitz
Staffordshire Bull Terrier
Standardbred
Swedish Vallhund
Tan
Tennessee Walker
Terrier
Thai Ridgeback
Tibetan Mastiff
Tibetan Spaniel
Tibetan Terrier
Tiger
Tonkinese
Tosa Inu
Toucan
Toy Fox Terrier
Treeing Walker Coonhound
Turkish Angora
Turkish Van
Vietnamese Pot Bellied
Vizsla
Weimaraner
Welsh Corgi
Welsh Springer Spaniel
Welsh Terrier
West Highland White Terrier Westie
Wheaten Terrier
Whippet
White German Shepherd
Wire-haired Pointing Griffon
Wirehaired Terrier
Yellow Labrador Retriever
Yorkshire Terrier Yorkie
Brief description of your dog's general nature *
Does your dog have any ongoing health problems or on any regular medications? Please describe ? *
Has the dog lived with children? *
No Yes
If so, please specify ages
If no, has the dog met children and what was his/her reaction?
What age groups were any children met?
Has the dog lived with other dogs? *
No Yes
If so, please specify age and sex
Has the dog lived with cats? *
No Yes
If so, please specify age and sex
Has the dog lived with or very close to animals other than cats and dogs ? *
No Yes
If so, please specify the species
Is the dog used to men and women? *
What is the dog's reaction if you approach them when it is eating? *
Please describe your dog's current diet - brands of food, scraps, dry or tinned, flavours, feeding times and quantities. Any dislikes? *
What commands does your dog know? And what commands are used? For example, sit or sit down; lie or lie down etc. Are the commands in English or another language ? *
Why do you need to rehome your dog? *
Where did you get the dog from initially? *
If the dog was purchased from an ANKC breeder please provide their kennel name/contact name and number and tell us if you have:
-contacted the breeder;
-if so, what was the breeders response as to why they can't help you
**your responses will be kept confidential unless you specifically authorise us to contact them on your behalf
Is the dog up to date with its annual vaccinations? *
No Yes
Date of last vaccination
Please attach a photo of your dogs vaccination history.
Is the dog housetrained? *
No Yes
Does the dog travel well in cars? If not, what do they do in the car to show you they are uncomfortable? How do you get them into the car? *
Do you leave the dog alone for any period of time? If so, how long for and do you have concerns about them being on their own? *
Has the dog ever been destructive in the house? Please describe *
Where does the dog sleep? *
Will the dog give up toys when commanded to? *
No Yes
Would you describe your dog as a gentle player or does he/she like "rough" play? Describe your dog's play activity, eg. favourite game, favourite toy, etc. *
How does your dog react to grooming/bathing? Do they tolerate having paws, ears or eyes touched ? *
How does your dog behave at the vets? Do they need muzzling and/or sedating for a vet visit? *
How does your dog react when he/she has done something wrong? How do you "tell him off"? *
Does the dog pull on the lead? *
Please tell us what equipment you use to walk your dog eg halti/harness/chain collar.
Does your dog return when called whilst off the lead? *
No Yes
Please indicate level of any urgency there may be in rehoming your dog. *
Urgent
High
Medium
Low
Lowest
First name *
Surname *
Address *
City *
Postcode *
Mobile Number *
Emailaddress *
Person providing information *
Owner
Agent
Inspector
*
Check the box to acknowledge you have answered all questions honestly. We do thank you for reaching out to us to help rehome your pet. Once you submit your form a member of our team will be in touch to discuss your application further. OUR RESCUE MAY NOT BE IN THE POSITION TO TAKE YOUR DOG INTO CARE AND WE MAY NOT BE SUCCESSFUL IN FINDING A HOME FOR YOUR DOG. If you need to surrender or rehome more than one animal please complete a separate form for each animal. A SURRENDER FEE OF $200 PER DOG MAY APPLY IF THE DOG IS PLACED INTO RESCUE'S CARE TO ASSIST WITH TRANSPORT AND VET COSTS THAT MAY BE INCURRED.