Dog Adoption Application

Dog adoption application

Animal you are interested in adopting *
I have met the dog I wish to adopt. (If not please submit a meet & greet form before submitting your adoption application) *
Applicant's First Name * Must be the primary carer for the animal
Applicant's Surname *
Street Address *
Suburb *
State *
Which Council area are you located in for dog registration purposes? *
If postal address is different to residential address
Post Code *
Phone Number *
Date of Birth * Applicant must be over 18 years of age
Email Address (non NT Gov or NT Schools email addresses please)(Please check spam folder as you will get an automatic email once you submit this form and future emails may also go there) * Please enter correctly as this is the main way we will contact you
Facebook Profile
Preferred Method of Contact *
Secondary contact for Council and microchip registrations - Full name and contact number
Please enter your photographic identification. ie Driver's Licence, Proof of Age Card, Passport *
What is your primary reason for adopting a dog? *
What characteristics do you most want in a dog? *
What characteristics do you least want in a dog? *
Under what circumstances, if any, would you consider euthenasing a dog? *
Under what circumstances, if any, would you consider surrendering a dog? *
Please tell us what you will do if you move? *
Please tell us why you wish to adopt this specific dog? *
Do you own other pets at the current time? *
Has your pet/s met the dog you wish to adopt?
If yes, please list their breeds, sex and ages. *
Are all of your pets desexed, vaccinated, wormed, microchipped & registered? *
Including yourself, how many people live in your household? *
Please list the ages & relationship of those who live in your home. *
Has everyone currently living in the household met the dog you wish to adopt? (Please note this is highly recommended to ensure the dog gets along with the entire household prior to adoption. This will help to ensure a successful adoption.) *
Is everyone in your household in agreement on adopting a new dog? *
Who will be responsible for care of the dog? *
Is anyone in your household allergic to animals? *
What are your current living arrangements? *
What type of property do you live in? *
Do you require Body Corporate approval? If yes please provide date of expected approval? * if you require Body corporate approval please let us know
Do you have permission from the landlord/strata to keep this animal at your home? *
Do you have permission from council to keep this animal at your home? *
What type of fencing do you have in the area the animal will be contained *
How high is your lowest fence? *
How large is the yard the animal will be contained in? *
If you do not have a fenced yard, how will you contain the dog? *
Where will this pet be predominantly living? *
Where will the animal sleep? *
On average, how many hours per day will your pet be left alone? *
What will you do with the animal when you go on vacation or away for work? *
What is your current occupation? *
Would you like a free Advance Puppy pack with a 40% off next purchase through the PAWS Darwin Community Vet Clinic? We sign you up for Advance mailing list if offer taken. Only for animals under 12 months of age at the time of adoption. *
How much do you expect to spend on dog food per month? *
Do you have or are you considering pet insurance? *
How much do you expect to spend on medical care each year? * Please consider worming, vaccinations, dental & other vet work as required.
Veterinarian's Name (Please research and supply details of a vet if you don't currently have one)(PAWS Darwin Community Vet Clinic is open to the public.) * If you have never owned a pet please tell us where you would go.
Veterinarian's Address * Again if you have never owned a pet please list where you would go
Veterinarian's Phone Number *
I understand that dogs need exercise both physical and mental and I am willing and able to provide the dog with both forms of exercise on a regular basis? *
What is the primary method of exercise you will use? *
I understand that this is an application only and it must be reviewed by your selection board. I understand the selection board will make the decision in the animal’s best interests and environment. Where there are multiple applications for the same animal, I understand I may not be the successful applicant. *
I understand that if my application for adoption is approved I am able and willing to pay the full adoption fee within 2 working days of the adoption approval email being received (as long as the animal is over 8 weeks old) *
I understand that the age and breed of PAWS Darwin animals is generally an estimate and is accuarate to the best of their knowledge only. *
I understand that the animal will be microchipped and the registration will be transferred to my name once the adoption has been finalised. I will ensure that I update my details as required directly with the microchip company when needed. *
I understand that the animal will be de-sexed if over 6 months. I agree to getting my animal de-sexed before 7 months for it's health and social behaviour if not old enough at adoption. *
I agree and understand that animals from PAWS Darwin have undergone a general health check and physical exam from a veterinarian before being placed for adoption and that I have been made aware of any medical conditions that the animal I wish to adopt currently has (if any). From the approval of the adoption forward I agree that I am responsible for any and all veterinary bills accrued in relation to the dog listed on this application form, and that PAWS Darwin will not be held liable for any further medical expenses. *
I agree and understand that animals from PAWS Darwin have been given up to date vaccinations and worming treatments up to the date of adoption in line with the age of the animal. I agree that I am responsible for any and all vaccination and worming treatment costs from the date of adoption and I agree to ensure all vet work is kept up to date for the remainder of the dogs life. PAWS Darwin will not be held liable for any further vaccination and worming expenses after adoption. *
I agree that PAWS Darwin has disclosed, to the best of their knowledge, any behavioural issues this animal displayed prior to adoption (if any) and that I adopt at my own risk. I release PAWS Darwin and related invididuals and entities from any and all liability or damages related to person(s) and/or property caused by the animal listed on this adoption application. *
I understand that the adoption includes four obedience class vouchers for dogs over 6 months and 6 puppy school vouchers for puppies under 6 months and that I agree to attend the allocated training session within the first three months of the adoption to ensure the best training outcomes for the dog. I agree that if any behaviour concerns emerge in the future I will work with PAWS Darwin to attempt to resolve these prior to either surrender or euthanasia. *
I agree that I intend to provide a home for this animal and care for this animal for the remainder of its natural life. If for reasons outside my control I can no longer care for the animal I will contact PAWS Darwin in the first instance to discuss options. I will surrender my dog to PAWS Darwin unless they provide me with written authority advising otherwise. I also agree to pay any fees associated with the surrender of my animal. *
I understand there is no “change of mind” refund if you choose not to keep the dog for the rest of its natural life through no fault of the dog. *
I understand that if surrender should be necessary I will fill in the surrender form whether I am eligible for a refund or not so that the animal can legally revert to PAWS Darwin’s ownership. *
I understand a refund will not be offered if 1. A new adopter has had a change in heart or circumstances. PAWS Darwin has created their adoption program to give new owners the best chance at finding their new pet and all precautions have been taken to ensure the new adopter has made the correct choice (as per adoption application process) 2. A behaviour issue has arisen that the new owner is not prepared to utilise PAWS Darwin's training vouchers or trainer advice. 3. A Health issue has occurred post adoption. 4. The animal has not completed their vaccination schedule and has been allowed out of the property or in uncontrolled areas putting the animal's health at risk. In the case of an animal being returned to the shelter under these conditions PAWS Darwin reserves the right to either request the surrender fee from the adopter or to waiver the surrender fee depending on circumstances *
I understand PAWS Darwin will only offer a refund under the following circumstances: 1. An animal has been adopted and has been involved in a substantiated attack or shown aggression towards people or other animals in the household. 2. An animal has an underlying health condition that affects the animals well being and preceded the adoption and was not disclosed prior to adoption. 3. An animal has displayed a serious behaviour issue that the new adopter has discussed with a PAWS Darwin Trainer and/or new adopter has attended the provided behaviour classes but a resolution has not been successful. *
I agree to abide by local council guidelines and keep my dog registered with my local council after the initial registration completed at adoption finalisation. *
I can certify that the answers in this application are complete, true and not misleading in any way. I am authorising you to contact landlords, associations and veterinarians as required to validate or to conduct a home assessment. *
I understand that when a decision has been made an email will be sent to the email address on this form and I know that it may go to my spam/junk folder so I will look there. (Please refrain from calling to check your application as it can take a little time especially with multiple applications and we will email asap.) *
Signature of Applicant. Please use your finger on touch screen or click and hold your left button to use your mouse above the line. * Please sign on screen or click and hold your left button to use your mouse.
Date of Application * Today's date
How did you hear about us? *