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Your Name *

Phone/Mobile *

Email *

Address Line 1 *

Address Line 2

Town/City *

Postcode *

Do you have any Children? *
YesNo

What are their ages?

Do you work? *
NoYes - Full TimeYes - Part TimeYes - Work From HomeNo - Retired

What is your occupation?

Who else lives at the property? *

Do they work? *
NoYes - Full TimeYes - Part TimeYes - Work From HomeNo - Retired

What is their occupation?

Type of Property *
Detached HouseSemi-Detached HouseTerraced HouseBungalowGround Floor FlatOther FlatMobile Home

Where do you live? *
City CentreSuburbsCountryside

Do you Own or Rent your Property? *
OwnRent (Landlord Permission Required)

Do you have a Secure Garden? *
YesNo

Boundary Type & Height

Do you have any other Dogs? *
YesNo

Do you have any Cats? *
YesNo

Are your pets vaccinated? *
YesNo

Are your pets neutered? *
YesNo

Do your neighbours have children?
YesNo

Do your neighbours have pets?
YesNo

Can we contact your vet for a reference?
YesNo

Have you had a rescue dog before? *
YesNo

Have you ever had to give a dog up? *
YesNo

Do you have experience of positive reward based training? *
YesNo

If your lifestyle changes, what fallback plans do you have in place so that the dog is safe and can stay with you? *

Is there any other information we should know? *

Are you able to pay the £450 rehoming fee?*
YesNo