Dog Application Form

Dog Adoption Form

This is a tale about a very special dog and a very special human. From the moment they met it was a match made in heaven. So they decided to make things official…
Date: *

Month Day Year Date Picker Icon
Name of adoptive dog applied for: *
Owner Details
Full Name: *

First Name Last Name
Contact Details: (Home)

Area Code Phone Number
(Work):

Area Code Phone Number
(Cell): *

Area Code Phone Number
E-mail: *
ID Number: *
Place of employment: *
Occupation: *
Are you employed permanently or on a temporary contract? *

Permanently Temporary
What are your working hours? *
How often and for what periods of time do you travel for work? *
Monthly Income: *

Address: *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

What type of dwelling do you live in (eg: house, flat, complex, farm, etc)? PLEASE NOTE: IF YOU LIVE IN A FLAT OR COMPLEX WE WILL REQUIRE A LETTER FROM THE BODY CORPORATE CONFIRMING PERMISSION TO OWN A PET. *
Is the property enclosed? *

Yes No
Please elaborate (eg: fence, wall, etc):
Height
Do the walls have electric fencing or security spikes? *

Electric Fencing Security Spikes None
Is your home situated on a main or busy road? *

Yes No
Have you ever had complaints from neighbours with regards to your animals? If yes, please supply details: *
Do you own or rent the property? If you rent, please furnish us with a letter of permission from your landlord. *

Own Rent
Do you have a swimming pool? *

Yes No
Is it enclosed/covered?

Yes No
Please supply details:
Pet Ownership Details

ATTENTION: Please note to supply details FOR EACH pet you that you have PREVIOUSLY owned(NOT CURRENTLY)
Have you previously owned any animals? *

Yes No
Pet 1: Species Breed?

Canine Feline
Pet 1: Where did the animal come from?
Pet 1: Age of animal when you first got it?
Pet 1: Gender?

Female Male
Pet 1: If a female, did she have any litters (puppies or kittens)?

Yes No Not Applicable
Pet 1: If male, did you use him for breeding or did he impregnate any female that you are aware of?

Yes No Not Applicable
Pet 1: How long did you own this animal for?
Pet 1: Sterilised?

Yes No
Pet 1: Reason for no longer owning the animal?
Pet 2: Species Breed?

Canine Feline
Pet 2: Where did the animal come from?
Pet 2: Age of animal when you first got it?
Pet 2: Gender?

Female Male
Pet 2: If a female, did she have any litters (puppies or kittens)?

Yes No Not Applicable
Pet 2: If male, did you use him for breeding or did he impregnate any female that you are aware of?

Yes No Not Applicable
Pet 2: How long did you own this animal for?
Pet 2: Sterilised?

Yes No
Pet 2: Reason for no longer owning the animal?
Pet 3: Species Breed?

Canine Feline
Pet 3: Where did the animal come from?
Pet 3: Age of animal when you first got it?
Pet 3: Gender?

Female Dog
Pet 3: If a female, did she have any litters (puppies or kittens)?

Yes No Not Applicable
Pet 3: If male, did you use him for breeding or did he impregnate any female that you are aware of?

Yes No Not Applicable
Pet 3: How long did you own this animal for?
Pet 3: Sterilised?

Yes No
Pet 3: Reason for no longer owning the animal?
ATTENTION: Please supply details FOR EACH pet you CURRENTLY own
Do you currently own animals? *

Yes No
How many pets do you currently own?
Pet 1: Species Breed?

Canine Feline
Pet 1: Where did the animal come from?
Pet 1: Age of animal when you first got it ?
Pet 1: Gender?

Female Male
Pet 1: If a female, did she have any litters (puppies or kittens)?

Yes No Not Applicable
Pet 1: If male, did you use him for breeding or did he impregnate any female that you are aware of?

Yes No Not Applicable
Pet 1: How long did you own this animal for?
Pet 1: Sterilised?

Yes No
Pet 2: Species Breed?

Canine Feline
Pet 2: Where did the animal come from?
Pet 2: Age of animal when you first got it ?
Pet 2: Gender?

Female Dog
Pet 2: If a female, did she have any litters (puppies or kittens)

Yes No Not Applicable
Pet 2: If male, did you use him for breeding or did he impregnate any female that you are aware of?

Yes No Not Applicable
Pet 2: How long did you own this animal for?
Pet 2: Sterilised?

Yes No
Pet 3: Species Breed?

Canine Feline
Pet 3: Where did the animal come from?
Pet 3: Age of animal when you first got it ?
Pet 3: Gender?

Female Male
Pet 3: If a female, did she have any litters (puppies or kittens)

Yes No Not Applicable
Pet 3: If male, did you use him for breeding or did he impregnate any female that you are aware of?

Yes No Not Applicable
Pet 3: How long did you own this animal for?
Pet 3: Sterilised?

Yes No
Pet 4: Species Breed?

Canine Feline
Pet 4: Where did the animal come from?
Pet 4: Age of animal when you first got it ?
Pet 4: Gender?

Female Dog
Pet 4: If a female, did she have any litters (puppies or kittens)

Yes No Not Applicable
Pet 4: If male, did you use him for breeding or did he impregnate any female that you are aware of?

Yes No Not Applicable
Pet 4: How long did you own this animal for?
Pet 4: Sterilised?

Yes No
Pet 5: Species Breed?

Canine Feline
Pet 5: Where did the animal come from?
Pet 5: Age of animal when you first got it ?
Pet 5: Gender?

Female Male
Pet 5: If a female, did she have any litters (puppies or kittens)

Yes No Not Applicable
Pet 5: If male, did you use him for breeding or did he impregnate any female that you are aware of?

Yes No Not Applicable
Pet 5: How long did you own this animal for?
Pet 5: Sterilised?

Yes No
If you own dogs, have they been exposed to and or interacted with cats *

Yes No Not Applicable
If Yes, have your dogs shown any form of aggression towards cats?

Yes No
Do any of your current animals display signs of aggression? *

Yes No Not Applicable
Have any of your current animals attacked another animal? *

Yes No Not Applicable
Please supply details:
If you own any unsterilised animals, please supply the reasons why the animal/s has not been sterilised: *
Have you ever surrendered a pet to a shelter, or given a pet away? *

Yes No
If yes, please supply reasons:
Have you ever had a pet go missing or has one of your pets been stolen? *

Yes No
If yes, please supply further information:
Have you had a sick pet on your property in the previous six months? *

Yes No
If yes, please supply details:
Have you ever had a pet euthenized? *

Yes No
If yes, please supply reasons:
Have you ever owned a dog who displayed/ is displaying behavior problems? *

Yes No Not Applicable
Please supply details of how you dealt with the behavioural problems and what the outcome was:
What type of dog are you wanting to adopt? *
What is the reason for you wanting to adopt a dog? *

Pet Friend for existing Pet Gift Companion Guard Dog
Please supply details of your vet: *
Do you have your own transport? *

Yes No
Do you have children? *

Yes No
IF YOU HAVE CHILDREN PLEASE READ THE FOLLOWING CAREFULLY!

PLEASE NOTE:

Given our extensive experience with adopting puppies and dogs to homes with young children, there are a number of important points to remember.
1. Having a puppy/dog is like having another child
2. Dogs/Puppies require constant training and supervision from an early age, affection, exercise, stimulation, companionship/constant attention.
3. Financial commitment
4. Lifetime commitment +- 15 years
5. Puppies nip, jump up, scratch and love to chew– that is normal!!!
Ages:
Has your child had exposure/interaction with puppies and dogs?

Yes No
Does anyone at home have any pet allergies? *

Yes No
If yes, please supply details:
Do you have any plans to emigrate or move? *

Yes No
Is someone home during the day? Please supply details: *
If not, how long will the pet be left on its own every day? *
Where will you leave the dog when you go out? *
Where will the dog sleep? *
Will it be necessary to chain/tie the dog up at any time for any reason? *

Yes No
If yes, please supply reasons/details:
What shelter will you provide for the dog if outside in the day? *
What will you do with your dog when you're away for long periods (eg: holidays)? *
How often will you walk/exercise the dog? *
What do you feed your pets? *
How often do you feed your pets? *
Have you ever approached another organisation to adopt a pet? *

Yes No
If yes, please elaborate:
Are you prepared to take the dog for training if necessary? *

Yes No
PLEASE NOTE: AN ADOPTION CAN BE DECLINED AT OUR OWN DISCRETION AT ANY STAGE OF THE PROCEEDINGS.
African Tails Adoption Agreement and Contract

I The Adopter agree:
1. That this adoption has been approved by African Tails, in its sole discretion, who reserves the right to:
  1. Visit the premises where the dog will be kept prior to adoption
  2. Visit the dog after adoption
2. On adoption of the dog, African Tails remain the custodians with the applicant being the care-giver. Should the dog be treated improperly in the opinion of African Tails, we reserve the right to remove the dog for whatever reason we see fit.
3. If the dog adopted is under the adequate sterilisation age, the dog will be sterilised at 5/6 months old by African Tails. Should the dog be sterilised by a private vet, proof of the sterilization papers must be submitted to African Tails immediately. Sterilisation is COMPULSORY. If an accidental pregnancy results at any time after adoption, the Adopter MUST report this to African Tails immediately.
4. NO BREEDING OF RESCUE DOGS IS PERMITTED UNDER ANY CIRCUMSTANCES.
5. The applicant accepts full responsibility for the adopted dog’s health and welfare. The Adopter agrees:
- To feed the dog and provide its full daily nutritional requirements by supplying a quality dog food.
- To provide the dog with shelter at all times.
- To provide proper housing for this dog.
- That this is a house pet, and will NOT be kept primarily or permanently outside. Dogs/cats cannot be left outside unattended anytime the owner is away. If the dog has access to a fenced outdoor area (while the owner is away), s/he must also have easy access to a secure indoor area at the same time to prevent exposure to the elements or pet theft. When outdoors, the dog must have access to an insulated dog house, and to shade in hot weather. Dogs MUST sleep indoors at night in the owner's house.
- Not to chain or tie up the dog – if found chained or tied African Tails will remove the dog immediately.
- To ensure that all vaccinations are kept up-to-date and in the case of injury or illness, the Adopter will ensure that the puppy/dog recieves the neccesary professional veterinary treatment.
- To identify the dog with a collar and identification tag.
- To notify African Tails within 24 hours should the dog go missing and within 48 hours should the dog die.
- That at no time will the dog roam the streets without his/her owner.
- That he/she will not allow the dog to be used as a watchdog on any property, residential, industrial or commercial premises – if found being used as such African Tails will remove the dog immediately.
- That he/she can afford the services of a private veterinary practitioner when necessary
1. In the event that the Adopters’ address changes at any time, he/she agrees to notify African Tails and will schedule a time with African Tails to inspect the new residence. The microchip details will also need to be updated.
2. The Adopter takes full　responsibility for the continuation of yearly vaccinations and rabies boosters, and flea and tick prevention. African Tails may contact the Adopter’s vet to verify that these shots are current, and furthermore to provide proper care for the adopted dog including shelter, shade, proper diet, fresh water, and love.
3. The Adopter will NOT make any physical alterations to any adopted rescue dog from African Tails (cropping ears, tail dock, etc)
4. The Adopter may not and will never use the adopted dog in any criminal activities including but not limited to fighting, trunking, or baiting. If the Adopter is found to have breached this clause in the contract, he/she will not only be reported to authorities for criminal prosecution, but will also be subject to a civil suit filed by African Tails.
5. The Adopter will allow African Tails or its agent to inspect the home before and/or after adoption and to allow African Tails or its agent to remove the adopted dog/s immediately if the home or surroundings are found to be unsuitable or terms of this agreement are not met. Notice of home visits will be arranged with a 24-hour notice unless if there is suspicion of mistreatment or neglect of the dog, or if the above terms are breached.
6. African Tails makes no warranties, representations or guarantees whatsoever as to the adult size, temperament, characteristics or health of said dog and hereby disclaim all implied or expressed warranties of fitness or merchantability.
7. African Tails will not be responsible for any medical care or costs thereof required after adoption of the dog. African Tails will not be held responsible for any sickness incurred by the said dog before or after receipt by the adopter.
8. The adopted dog must remain in the custody and possession of the Adopter. The Adopter may not sell, trade, give away or dispose of this pet in any way. If the Adopter cannot keep this dog for any reason, THEY MUST NOTIFY AFRICAN TAILS IMMEDIATELY. THE ANIMAL MAY NOT BE SURRENDERED TO ANY OTHER ANIMAL WELFARE ORGANISATION. The onus will be on the owner to find a new loving home for the pet that African Tails needs to approve. We will need to do a house inspection etc to ensure the new home is satisfactory. African Tails will try and assist with finding a new home if possible.
9. Please note, that African Tails does NOT do trial basis adoptions. If an Adopter surrenders an animal back to our rescue, he/she will not be an eligible to adopt any other animal from African Tails unless there are extenuating circumstances and African Tails management have approved a future adoption with another animal from the facility.
10. Should any part of the Adoption Application form or information supplied by the Adopter have been falsified in any way, the adoption is null and void and the dog must be surrendered back to African Tails. We will enforce this strictly and we will ensue all legal forms of action to repossess the dog. The Adopter will be responsible for any and all attorney, court filing fees, other legal service fees or any additional expenditures incurred in order to enforce the breach of contract due to false information.
I have read and agree to and understand the above agreement: *

Yes No
Why do we ask an adoption fee?
- Fostering a dog/cat means that we need to feed it, de-worm it, groom it (including tick & flea treatments) and costs of all necessary veterinary treatments (vaccinations, sterilisations and other treatments if necessary). Adoption fees cover these primary care costs. Adopting a dog or cat means making a financial commitment for the rest of your pets’ life, so to ensure a sensible, responsible decision and as reassurance that those who adopt our doggies are willing and able to afford the costs of caring for them properly we ask that people “pay” a small fee for the invaluable gift of loving and loyal companionship.
- Purchasing a pedigree from a breeder usually costs within the region of R1500. Purchasing a dog from a “backyard” breeder normally costs about R500 – this usually EXCLUDES any initial vaccinations and sterilisation (which costs in the region of R1200 at a private vet) So although these fees seem “steep” – it’s actually a real bargain!
Adoption Fees:
- The fee for dogs and puppies is R700.
- This adoption fee covers all vaccinations up to the date of adoption, sterilisation and microchipping.
- Depending on the vaccination status of the animal adopted, further vaccinations due thereafter can be done at your own private vet at your own expense. Alternatively animals adopted from African Tails can have vaccinations done at African Tails at a cost of R150.00
- All monies paid for adoption of an animal is non-refundable.
Banking Details
Nedbank Sea Point
Account Name: African Tails
Current Acc no: 1069401978
Branch code: 106909(13) – 8 digits are required please add the extra “13”
Reference: Adoption & Pets name

The moment of truth…

I, Mr/Mrs/Ms/Dr accept the conditions above and agree to pay R 700.00 to African Tails to cover the cost of vaccinations already done, de-worming, de-fleaing, microchipping and sterilisation as well as any other medical treatment rendered to date.
I have read and agree to and understand the above agreement: *

Yes No
CONGRATULATIONS!

You’ve given this tale a truly happy ending… All our rescues remain forever in our hearts so please do keep us updated on their progress through their new and happy lives.
Should be Empty:

Dog Adoption Form

Pet Ownership Details

CONGRATULATIONS!