Adoption Application

Name and Title *

Full address with postcode*

Home telephone number*

Mobile telephone number

Your Email Address *

Please confirm that you are over 18*
 Yes No

Which age bracket are you in?*
 18-40 41-70 71+

Are you seeking to adopt a*
 Dog Bitch Either

Are you seeking to adopt a
 Puppy Adult Oldie No preference

Your occupation

Your normal hours of work

Do you work from home?
 Never Sometimes Often Always

Number of persons at the above address aged over 18

Number of persons at the above address aged under 18

Ages of your children under 12, if any?

Ages of children under 12 who regularly visit you, if any?

Will interactions between young children and the adopted dog always be supervised?*
 Yes No

Have any of the above ever been banned from keeping dogs? *
 Yes No

Do you own any other dogs? If yes please give breed/s, gender, whether neutered, and age/s

Do you own any cats? If yes please give age/s

Do you own any other pets (e.g. horses, house rabbits, caged rabbits, ferrets, rodents)?

Do you own or rent your home? (If your home is rented we will need to see a letter of permission from your landlord.)*
 Own Rent

Is your home a *
 House  Bungalow Ground floor flat Upstairs flat Mobile home Houseboat Other

How busy is the street on which the property is located?
 Very busy Busy Only busy at peak times Quiet Very quiet

Does the property open straight on to the street ?
 Yes No

Is the garden, or an area of the garden, secure?
 Yes No

How large is the secure area?

How high is the fencing surrounding the secure area?

If there is no secure area what arrangements will be made for toileting?

Do you have previous experience of raising a puppy?
 Yes No

Would you consider adopting a whippet with health issues?
 Yes No

Would you consider adopting a whippet with behavioural issues?
 Yes No

Would you consider adopting two whippets needing a home together?
 Yes No

Have you owned a dog/s before? If yes please give breed/s, and if adopted from which rescue

Have you ever been homechecked by another rescue? If so which and when?

Has another rescue ever refused your application? If so which, when and why?

Will the adopted dog live in your home with you day and night?
 Yes No

If you have answered yes to the above, where will the dog sleep?

If you have answered no to the above, where do you intend that the dog live?

What is the longest period of time for which the adopted dog is likely to be left alone on a daily basis?

What is the longest period of time for which the adopted dog is likely to be left alone on a weekly or less occasional basis?

What arrangements will be made for the adopted dog if you have to go away?

Have you any previous experience of whippets/whippet crosses?
 Yes No

Are you aware of the needs and character traits of the whippet?*
 Yes  No

Are you prepared to travel to collect the dog/s you adopt? If so, how far can you travel?
 Not prepared to travel Prepared to travel up to 25 miles in total Prepared to travel up to 50 miles in total Prepared to travel up to 100 miles in total Prepared to travel up to 150 miles in total Prepared to travel 200 miles plus in total

Please give any other relevant information that may help your application here

Please confirm you meet the minimum requirements:
1) Secure fenced garden, minimum 5ft high.
2) Dog is left alone for no more than approximately 4 hours a day on a regular basis.
3) You understand the patience, time and expense that the long term commitment of owning a dog requires.
Check here if you accept these terms.

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