Application to Adopt a Dog

Name *

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Are you employed? *

Yes

No

Retired

Do you work from home?

Yes (Permanently)

Yes (Temporarily due to Covid / Lockdown)

No

Have you ever returned a dog to the rescue organisation or re-homed a dog belonging to you? *

Yes

No

Do you live alone? *

If you live alone, the charity reserves the right to ask you for your next of kin at home-check, as we need to know who will support you and your dog in the event of an emergency.

Yes

No

Do you have any children who regularly visit? *

E.g. Grandchildren. Do not include children who live at the property.

Yes

No

What kind of accommodation do you live in? *

House

Flat

Maisonette

Bungalow

Other

Is accommodation owned or rented? *

If in a rental property we will need you to provide evidence to our home checker. Proof of rental agreement will need to be provided, and a written agreement from your landlord to prove that you can keep a pet in the property. This will need to be provided before the home check.

Owned

Rented

Does your property have a secure back garden? *

We will ask the home checker to provide photos from the visit.

Yes

No

Is the front access secure? *

Yes

No

In which areas of the home will the dog be allowed to go? *

Anywhere in the home

Only in certain areas

How active would you describe your lifestyle? *

High (Runs / Hiking)

Moderate (Long walks)

Low (Short walks)

Do you have other pets? *

Yes

No

When is the earliest date you would want to adopt the dog? *

MM

DD

YYYY

Have you registered with a vet? *

Yes

No

Will you veterinary clinic be willing to give references for you?

Yes

No

If you are planning to adopt a puppy you must have him/her sterilised as soon as the dog is old enough. Are you prepared to provide evidence of this?

Yes

No

Have you applied to any other rescue organisations recently? *

Yes

No

Terms *

In the event were you can no longer care for the dog(s) you must without exception inform Freedom Angels Romania immediately and the rescue will arrange to find a suitable foster home for the dog. Time should always be given to the rescue until a new home is found. The dog should NEVER BE REHOMED/SOLD/OR PROMOTED in any way by the adopting family. The dog ALWAYS remains the property of Freedom Angels Romania. Please confirm you have read and agree with these terms.

Yes

No

PetTrac - Microchip registration consent *

Your dog will be Microchipped with a dual registration microchip with the Company PetTrac. PetTrac will hold both your details (in the event of successful application) and also those of Freedom Angels Romania. We therefore require your consent to pass on you details (in the event of a successful application) to PetTrac. I hereby apply to become the registered keeper of this pet and confirm I am over 16 years old or over. I confirm that this pet will be living with me at the address given above. I confirm that the information I have given is accurate. I also understand that current legislation regarding dogs requires me to keep these details up to date at all times. PetTrac and Freedom Angels Romania reserves the right to contact you in the future to remind you of this. I understand that this information will be retained by PetTrac and Freedom Angels Romania in order to fulfil the service offered by the database, and disclosed to any person who has requested and received authorisation, who is involved in securing the welfare of this pet. It may also be used for the enforcement of the microchipping regulations, and for the prevention or detection of crime relating to the welfare of dogs. Please confirm that you agree to these terms.

Yes

No