ANGELS SMALL PAWS HOMECHECK REQUEST
DO NOT FILL OUT THIS FORM FOR ENQUIRIES - IT IS FOR HOMECHECK REQUESTS ONLY
FOR ENQUIRIES EMAIL - homecheckme@gmail.com

Homecheck information PLEASE FILL IN ALL FIELDS ON THIS FORM. Our minimum adoption donation is £250 (the donation is higher for pups and ex-breeders) to be paid in full at adoption and is NOT REFUNDABLE, this includes neutering, vaccinations, flea, worming and chipped, plus 4weeks free pet insurance and lifetime back up from the rescue.
You will need to travel to meet any of our dogs, with resident dogs and children, we are based in the East Midlands.
FIRST NAME *
Your answer
SURNAME *
Your answer
ARE YOU ON FACEBOOK, IF SO WHAT IS YOUR FACEBOOK NAME? *
Your answer
1ST LINE OF ADDRESS INCLUDE HOUSE NUMBER & STREET NAME *
Your answer
TOWN OR CITY *
Your answer
POSTCODE *
Your answer
PHONE NUMBER, INCLUDE MOBILE *
Your answer
YOUR FULL POSTCODE IS USED ON A CLOSED FACEBOOK GROUP, TO ALLOW US TO FIND A HOMECHECKER WHO IS THE CLOSEST MOST SUITABLE MATCH FOR YOUR HOMECHECK. ONCE YOUR HOMECHECK IS COVERED THE POST IS DELETED FROM THE GROUP. PLEASE TICK TO AGREE OR DISAGREE (PLEASE NOTE IF YOU DO NOT AGREE WE ARE UNABLE TO CARRY OUT YOUR HOMECHECK) *
EMAIL *
Your answer
HOME RENTED OR OWNED - IF RENTED NEED PROOF FROM LANDLORD YOU CAN OWN DOG & HOW MANY? (Please show homechecker) *
OUR DOGS ARE FOSTERED IN DERBY & SURROUNDING AREAS, ARE YOU ABLE TO TRAVEL WITH ANY RESIDENT DOGS OR CHILDREN TO MEET A DOG? (IF NOT WE ARE UNABLE TO GO AHEAD WITH A HOMECHECK) *
IS YOUR GARDEN SECURE, WHAT IS THE HEIGHT OF YOUR FENCE? *
Your answer
DO YOU WORK? *
STATE START & END TIME OF WORKING DAY & HOW MANY DAYS A WEEK, INCLUDE TRAVEL TIMES, FOR ALL RESIDENT ADULTS? *
Your answer
HOW MANY HOURS WOULD A DOG BE LEFT? *
Your answer
DO YOU HAVE ANY RESIDENT OR VISITING CHILDREN? *
HOW MANY CHILDREN? AGES OF CHILDREN? *
Your answer
DO YOU HAVE ANY DOGS? *
IF YOU HAVE A DOG WHAT IS THEIR BREED, AGE & ARE THEY SPAYED/NEUTERED ? *
Your answer
DO YOU HAVE ANY OTHER PETS IF SO PLEASE STATE TYPE OF ANIMAL? *
Your answer
IS THERE A PARTICULAR DOG YOU ARE INTERESTED IN ADOPTING? *
Your answer
HAVE YOU APPLIED TO ANY OTHER RESCUE, IF SO PLEASE STATE WHICH RESCUE & WHEN *
Your answer
The information you supply to us in this form & at your homecheck – which may include personal data – will be stored securely and used by us, Angels Small Paws Dog Rescue for the purpose of your homecheck and the adoption of a dog. We will not share your details with any other agency without contacting you for your permission. IF YOU DO NOT AGREE PLEASE DO NOT SEND THIS FORM *
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