Enquiry about Dogs for Adoption

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

If you would like to know more about a dog from our "Adopt" page please complete and submit this form.
NOTE: For any questions about dogs in the Pound, please phone DCC 03 477 4000. We are unable to answer any questions about the Pound dogs.

First name *

Surname *

Phone number *

Email address *

Your physical address *

Suburb *

City *

Date of birth *

dd/mm/yyyy - This is a DCC requirement

Please note your section must be fully fenced to adopt from us.

If the section is not yet fully fenced but will be please give details.

What is the name of the dog you are interested in? *

What dogs (if any) are at your place already? *

Tick all that apply

entire males

castrated males

bitches

no dogs

Other:

Required

Are there any types of dogs that your current dog doesn't like?

How many dogs have you owned? *

What breeds of dogs have you owned?

Would you be able to provide your adopted dog with a daily walk/run? *

Mark only one oval

yes

usually

Other:

Your family *

Tick all that apply

children/visitors 0-5 years

children/visitors 6-12 years

cats

chickens free range

chickens enclosed

rabbits

sheep

Other:

Required

Human companionship *

How long, on an average day, would you leave the dog for? Mark only one oval.

0-1 hour

2-3 hours

4-5 hours

6-7 hours

8-9 hours

9-10 hours

Other:

Renting or own home - Do you own and live in the home where the dog will be kept? *

Mark only one oval - If your name is not on the title for the property, then you must select "renting" even if you are not actually paying rent.

Own home

Renting

If renting ... *

Written permission is required

I have written permission

I am obtaining written permission

Not applicable

Fencing - Boundary fence *

This question is about the fence that goes right around the property. Please tick any options that apply. Does the boundary fence contain areas of:

wire sheep fencing

hedge only with no netting

loose boards, loose iron, gaps

none of the above

Other:

Required

What is the lowest point of the fence & gate that goes right around the property?

less than 1m (3 ft)

1m (3 ft)

1.2m (4 ft)

1.5m (5 ft)

1.8m (6 ft)

higher than 1.8m (6 ft)

Other:

Fencing - inner fence

This question is about the fence surrounding any place where the dog will be confined without supervision. Please tick any options that apply. Does the inner fence contain areas of:

wire sheep fencing

hedge only with no netting

loose boards, loose iron, gaps

none of above

Other:

What is the lowest point of the fence and gate surrounding any place where the dog will be confined without supervision? Mark only one oval.

less than 1m (3 ft)

1m (3 ft)

1.2m (4 ft)

1.5 m (5 ft)

1.8m (6 ft)

higher than 1.8m (6 ft)

Other:

Clear selection

Where will the dog be kept during the day? *

Inside house

Inside house with access to outside

Outside with shelter

In dog motel

Other:

Required

Where will the dog be kept during the night? *

Inside house

Inside house with access to outside

Outside with shelter

In dog motel

Other:

Required

Comments or requests?

Submit

Clear form

Never submit passwords through Google Forms.

Forms

This form was created inside of Dog Rescue Dunedin Charitable Trust.