Adoption application

Your full name

Email

ID required/flexibility welcome. Data Will be deleted after processing

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Phone number

Mobile number

Have ever been convicted of animal cruelty?

If yes please give details

Full address inc town/ city

Post code

Proof of address required/ Utility accepted. Data will be deleted after processing

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Have you any disabilities?

If yes please give details

What dog/s are you in the process of adopting?

Where did you see it?

Have you had a dog before?

If yes what happened to it?

Have you any mental issues?

If yes give details

Have you ever been turned down by another rescue?

If yes give details

Age range

Proof of age required. Data will be deleted after processing

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Are there any kids in your household?

If yes please give details age amount etc

Work status

Please provide proof of employment. Data will be deleted after processing

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How did you hear about Leicestershire Dogs?

About where you live

If renting did you get permission from your landlord to keep a dog?

We need two professional references can you provide 2 referees?

Professional referee1. Full address ,name and number

Professional referee 2. Full address, name and number

Do I have permission to contact your referees?

Do you have a vet?

If yes please give name , number and full address

If the adoption wasn't working out what would you do with the dog?

How would you confine the dog to your property?

Have you got a garden?

Have you read our terms and conditions?

What issues can you cope with?

Mild aggression

Dominance

The odd accident

Pulling on lead

Nipping

Barking at pother dogs

Hyperactive

Separation anxiety

Chewing

Jumping on furniture

What issues can you not cope with?

Pulling on lead

Nipping

Odd accidents

Jumping up

Mild aggression

Dominance

Barking at other dogs

Barking at people

Hyperactive

Separation anxiety

Chewing stuff

Jumping on furniture

I will keep this dog no matter what train it or get it trained if I have to

I will keep my word

If I have to give it back I will not expect a refund

If it's an bitch not spayed I will have proof of getting it spayed within 3 months

I agtee to Leicestershire Dogs terms

I agree to Leicestershire Dogs terms and conditions

On-line

Adoption application