Adoption application

You are applying for Maple

Dog and enquiry

Dog of interestI am interested in

Applicant

Full nameStreet addressStreet address line twoCity or townPostcodeEmailHome phoneMobile phone

Please add the best number for volunteers to contact you about your application.

Date of birthAre there any medical issues we need to consider during the matching process?

Household and home

Have you previously owned a dog?If previously adopted, which organisation was the dog from?Vet reference (please call your vet and give notice that we will call. If you have not been to a vet before, please register with one soon.) I am able to collect this dogWhen will you be ready to adopt?Is anyone in your home allergic to dogs?Adults in the homeChildren in the homeChildren's agesDo you plan on having children?If you have other pets, please give details including agesI live in aDo you own or rent?If rented, does your tenancy agreement allow a dog?Approximate wall/fence height

Lifestyle and experience

Do you work?How many hours a day would the dog be left alone?Is someone at home during the day? If so, who?When no-one is home, where will the dog be kept?Where would the dog sleep at night?When you go on holiday, who will care for the dog?What experience do you have with rescue dogs?What is a reasonable time for a dog to completely settle in a new home?Additional reference, if desiredDo you have any additional comments, questions or concerns?

Declarations

I confirm that the information I have provided is accurate and complete to the best of my knowledge. I understand that Immingham Dogs Home may carry out a home check or ask for further information before an adoption is agreed. I understand that over the course of its life a dog can develop illnesses or have an accident and this may lead to substantial vet costs. I am prepared to accept any costs that may arise. I accept that many dogs are rescue dogs and may have spent time living on the streets or have been abused before they came into the centre. I understand that many dogs may have been strays or lived in kennels for a long period. They may not be house trained and may have no obedience training. I am prepared to offer patience, understanding and time to adjust. I understand that Immingham Dogs Home may not know everything about a dog's past, behaviour or medical history. I accept that if an adoption does not work out, I will be expected to return the dog to Immingham Dogs Home. I consent to the personal information contained within this form being recorded and processed by Immingham Dogs Home for the purposes of my adoption application and in accordance with the Privacy Policy. Unfortunately we cannot process your application without this consent.

Once you send this form, the team will contact you if your application is a possible match.