Adoption Application APPLICANTFull Name First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Home Telephone Number*Mobile Telephone NumberEmail Address Name of the Dog you are interested in* Please note – we are only processing applications for dogs who are currently available on our Website or Facebook Page.ABOUT YOU AND YOUR FAMILYNumber of Adults in the Home*Please Select The Appropriate Age Ranges For The Adults* 18 - 35 36 - 50 51 - 70 71 + Number of Children in the Home*If Applicable, Please Enter The Number Of Children Under 10Do you go out to work?* Yes No If Yes, how many hours per day?*Does your partner go out to work?* Yes No If Yes, how many hours per day?*ABOUT YOUR HOME AND GARDENHave you ever owned a dog?* Yes No Do you currently own any other dogs?* Yes No If yes, please give details of breed, age, gender and whether they are neutered*Have you ever adopted a dog before?* Yes No Why do you want to adopt a Rescue dog?* Do You Own Your Own Home?* Yes No Please note: If you live in rented accommodation you will need to have your landlord's written permission to keep a pet.Do You Have A Secure Garden?* Yes No Please indicate height of fencing/boundary at its lowest point OTHER PETSDo you have any cats?* Yes No Are they familiar with dogs? Yes No N/A Do you have any other pets and/or livestock?* Yes No If yes, please state what animals you own?* RESPONSIBILITY FOR AN ADOPTED DOGHave you taken into consideration the costs of owning a dog?* Yes No Where will the dog sleep? Where will the dog stay during the day? Would you be prepared to use an indoor crate if necessary?* Yes No If so where would it be placed? What will happen to the dog when you go on holiday? Are you aware of the different types of coat care required?* Yes No Are you prepared to groom yourself or pay for grooming?* Yes No Are you prepared to give the dog any necessary training such as classes?* Yes No Have you ever given up a dog to a rescue organisation?* Yes No ADDITIONAL INFORMATIONWhat activities are you hoping to do with your dog? e.g. Walking, Agility, Obedience, CuddlingPlease give availability for a Home Check to be carried out (FODDR would like to meet all the occupants of the home if possible)Have You Ever Had A Conviction For A Criminal Offence Involving Cruelty, Violence Or The Threat Of Violence To Other People Or Animals?* Yes No I declare that the information provided in this application form is true and accurate. I undertake to inform FODDR if/when we no longer wish to adopt a dogApplicant Digital Signature (Full Print Name)* Date* MM slash DD slash YYYY