Rehoming Form
Our
minimum
donation is £150; if you can't afford this please
do not
fill in the form
Only complete this form if you have been asked to do so by a member of EDR
For general enquires use our
Enquiry Form
*
indicates required fields
*
What size/type/name of dog are you interested in?:
*
Would you prefer a male or a female?:
Please Select
Male
Female
Don't Mind
*
Would you prefer an older or younger dog?:
Please Select
Puppy [under 12 months]
Young Dog [under 5 years]
Older Dog [Over 5 years]
Don't Mind
Any other specific requirements?:
*
Name of adopter:
*
Age of adopter:
Please Select
Under 20
21-30
31-50
51-60
61-70
Over 70
*
Address of adopter:
*
Contact Numbers:
*
Email address:
*
Occupation of adopter:
*
Occupations of other members of the household:
*
Adopter: hobbies and pastimes:
*
Do you have transport?:
Please Select
Yes
No
by arrangement
*
How many other adults in your household?:
*
Do you have children & what are their ages?:
*
Any other regular visitors?:
*
Does anyone have any allergies or special needs?:
*
Are there any other dogs in your household?:
Please Select
Yes
No
Sometimes
*
Do you have any other pets in your household?:
Please Select
Yes - Give details below
No
Sometimes
If yes, what other pets do you have?:
*
Do you have any livestock?:
Please Select
Yes
No
Sometimes
*
What kind of house do you live in?:
Please Select
Flat/Maisonette
House/Bungalow
Bedsit/Caravan
*
Is your home rented or owned?:
Please Select
I rent my home [Private Landlord]
I rent my home [Council/HA]
I own my home
Other - Please explain below
*
How long have you lived at your current address?:
Please Select
Less than 1 year
1-6 years
Over 6 years
*
Do you have any plans to move?:
Please Select
Yes
No
Not Sure
*
What is the location of your home?:
Please Select
Main/High Road
Estate Road
Quiet Road
Cul de Sac
Other - Please explain below
*
Do you have [access to] a garden?:
Please Select
Yes
No
Other - Please explain below
What size is your garden?:
Is your garden fenced?:
Please Select
Yes
No
Other - Please explain below
How high is the fencing?:
Please Select
Under 5 feet high
5-6 feet high
Over 6 feet high
Is the access to & from your garden secure?:
Please Select
Yes
No
Do you have a fish pond or swimming pool?:
Please Select
Yes
No
*
Where do you plan to exercise the dog?:
*
Do you work? What are your working hours?:
Will the dog be left at home while you work?:
Please Select
Yes
No
Other- Please explain below
*
Where will the dog be left while you are out?:
*
Who will care for the dog while you are away?:
*
Where will the dog sleep?:
*
Will the dog be allowed on beds/furniture?:
Please Select
Yes
No
Other - Please explain below
*
Have you owned a dog before?:
Please Select
Yes
No
Other - Please explain below
What breed/s of dog have you owned?:
What happened to your previous dogs?:
*
Would your Vet give you a reference letter?:
Please Select
Yes
No
Not sure
*
Have you been home-checked by another rescue?:
Please Select
Yes
No
Not sure
Which Rescue?:
*
A minimum adoption donation of £150 is required:
Please Select
I can donate a minimum of £150
I can't donate a minimum of £150
*
Any other relevant information?:
*
Where did you hear about Enfield Dog Rescue?:
Please click on the Submit button to submit the form details.
All images are the copyright of Enfield Dog Rescue
©
2009
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