Tucker

Title*

Forename(s)*

Surname*

Telephone*

Mobile*

Email Address*

Address*

Postcode*

Are you a member of team safe?*
YesNo

If No, Would You Like To Hear More About Us?*
YesNo

Tell us about yourself…

Have you previously applied to stray aid for a cat or dog?*
YesNo

If yes, When and what type of pet?*

What type of pet are you looking for?
(e.g. breed, age, sex)*

Have you owned a dog before?*
YesNo

If yes, please state for how long you owned him / her and give any relevant detail*

Are there any dogs or other pets living at your property or visiting regularly?*
YesNo

If yes, please give details*

Why do you want a new dog?*

What type of accommodation do you live in?*
HouseFlatBungalow

Other (Please Specify)

Are you allowed to keep dogs on your property?*
YesNo

If yes, how many?

Do you OWN, RENT or SHARE your property?*
OwnRentShare

If it is not your property, do you have written permission from the landlord or homeowner to keep a dog?*
YesNo

If accommodation is leased/rented we require written permission from the homeowner, or sight of the section of the lease where authorisation is granted.

Will you be moving shortly?*
YesNo

Do you have your own garden/yard?*
YesNo

Please upload a photo*

Will your new pet be exercised regularly?*
YesNo

Does your accommodation open directly onto a busy road?*
YesNo

If your garden is not secure, would you be prepared to make it so?*
YesNoAlready Secure

Please provide photos of existing outside space*

How many people live in your household?*

Adults*

Children*

Ages of Children*

Is a new family member or baby expected in the next 3 months?*
YesNo

IF YES, Please provide further information

Are there children who regularly visit your household?
(e.g. grand children, friend?*
YesNo

IF YES, how often and what ages?

Is anybody in your household allergic to dogs/an asthma sufferer?*
YesNo

If yes, please give details

Please state where the dogs will stay during the night*

Please provide a photo*

Please state where the dogs will stay during the day*

Please provide a photo*

Please provide any further information that may be relevant*

Please provide a photo if appropriate

Do you have any holidays planned?*
YesNo

If yes, when and for what duration?*

Please state where the dog will stay if you go away*

On an average day, how long will your dog be left on its own and why?*

If left on a regular basis, what provision will be made to provide company and toilet breaks for your rescue dog?*

Please indicate how much you think it may cost to:

Vaccinate your dog each year?*

Insure your pet each year?*

Feed your dog each week?*

Please give the name of your veterinary surgeon, if applicable:

Where did you hear about stray aid and our dogs?*

Are you happy for one of our staff members or volunteers to visit your home?*
YesNo

If no, give details

Have you ever had to have a pet rehomed?*
YesNo

If yes, give details

Have you, or anyone in your household, ever been accused of, or convicted of, an offence of neglect or cruelty against animals?*
YesNo

If yes, give details

Are there any other comments you would like to make to support your application?

By signing this form, I state that all information provided is accurate, and agree to be bound by Stray Aid’s Terms and Conditions.

I confirm that I have read the terms and conditions before completing this Registration Form and I accept and agree to be bound by them?*
I CAN CONFIRMI CAN NOT CONFIRM

Terms and Conditions

SIGNATURE* (Please state name online)

TYPE FULL NAME*

Date*

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