KWWSPCA Expression of interest form

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The following is the first step in adopting a dog or a puppy from the KWWSPCA. We ask these questions to get an idea of whether the dog that interests you will be a good fit for your family. These questions are necessary and we apologise if they are a little sensitive. However, from experience, it is essential that we have this information. Under GDPR this information will not be shared with a third party without your consent and in such cases would only be shared for the purpose of a home check. All dogs are the property of the KWWSPCA and are rehomed at our discretion. We cannot take any responsibility for the behaviour or temperament of any dog after rehoming.

Helpline: 087 1279835
Reg. Charity No: CHY 6280

Email *

Name of dog that interests you? *

Are you applying on your own behalf? *

Yes

Other:

How long have you been considering getting a dog? *

Why are you interested in this particular dog? *

Have you researched this particular breed of dog or have you prior knowledge of the breed? *

Your Full name: *

Address: *

Eircode: *

Contact phone number: *

Email address: *

Year of birth: *

How many adults are there in your home? *

How many children are there in your home ? *

Please state their ages *

What experience of dogs do the children in your home have? *

What is your relationship to the other people in your home (Family/friend/flatmate/partner, etc?) *

Is everyone in the home in agreement with having a dog? *

Yes

What is your occupation? *

What are the occupations of the other adults in your home? *

Does anyone in the home suffer from allergies or asthma? *

Yes

Does anyone in the home have a fear of dogs? *

Yes

Who will be mainly responsible for the care of the dog? *

Who will mainly exercise the dog? *

Have you had a dog before as an adult? *

Yes

If so, what breed of dog and how long did you have it for? *

Do you currently have a dog or dogs? *

Yes

If yes, what breed(s) and ages are they? (if no, please state n/a) *

What gender are they? *

Male

Female

n/a

Do they get on well with other dogs? *

Yes

n/a

Are they territorial in their home? *

Yes

n/a

Would they show jealousy towards another dog? *

Yes

n/a

Are they neutered? *

Yes

n/a

Are they up to date with their vaccinations and recently treated for worms and fleas? *

Yes

n/a

Have you ever given up ownership of a dog? *

Yes

If so, why? *

Have you ever sold a dog? *

Yes

Are there cats in your home or garden? *

Yes

Are there other pets, animals or fowl on your property? *

Do you regularly have visits from other dogs or have other dogs staying on your property? *

Do you regularly visit or stay with others who have dogs on their property? *

If working from home are you involved in childcare or animal care? *

Is there someone at home during the day? *

How much alone time would a dog typically have on a daily basis? *

How many days a week might a dog be left alone? *

Where will the dog spend most of its time? *

Where would the dog spend its time when you are out? *

Where in your home or property will the dog sleep? *

Will the dog sleep in a dog crate? *

Yes

Where will you exercise the dog? *

For how long and how often will you exercise the dog? *

Will you exercise the dog on a lead? *

Where might you allow a dog off a lead? *

Would your dog be permitted out onto the local green alone? *

Yes

Will your children exercise the dog alone? *

If someone is at home now, might they plan on returning to work in the future? *

If the answer to the above is yes, what measures will you put in place to ensure that the dog has adequate companionship and gets adequate exercise, and is not left alone for long periods? *

What arrangements will you put in place if you are going away? *

Do you live in an apartment, house or other? *

House on housing estate

Rural home

Farm

Apartment

Inner City Home

Do you own the property? *

Yes

If renting, whose name is the lease under ? *

If living in someone else's house, who is the homeowner? *

Have we your permission to contact the landlord or home owner to verify permission to having a dog?

Yes

Clear selection

If so, please provide contact details? *

Is your garden entirely secure? *

Yes

What size is your garden? *

Small

Medium

Large

No Garden

What type and height are the surrounds (wall, fence, wire, hedge etc.)? *

Could a dog escape from your home or garden? *

Yes

Could a dog get out over, under, or through a gate? *

Yes

Has a dog ever escaped from your garden? *

Yes

Is your front garden accessible from the back garden? *

Do you lock your gates? *

Yes

Do you have electric gates? *

Yes

Does your front door open onto a street? *

Yes

Do you intend moving home in the future? *

Yes

If yes, will your new home permit pets? *

Have you any holiday planned over the next few months? *

When would you be ready to take a dog? *

Do you agree to a home check? *

Yes

Do you consent for your details to be used for the purpose of a Home Check should you be considered suitable for the adoption of a rescue dog? *

Yes

Do you agree to buy a Dog Licence and a Dog Collar Tag for any dog that you adopt. *

Yes

Do you agree that if you adopt a dog that is a restricted breed, the dog will wear a muzzle and stay on the lead whenever it is in a public place. *

Yes

Signed: *

Is there anything further that you would like to add in support of your application? *

Date *

YYYY

A copy of your responses will be emailed to the address you provided.

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