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Address

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Age

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Work Status

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Your Home And Family

How many adults live in your household?

How many children live in your household?

What are the children's ages?

How many other dogs do you have?

What are your dogs breeds, sexes and ages?

Are all current dogs desexed and vaccinated (proof may be requested)

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If you own any other pets, please list here:

Current living status:

If Other Living Status, please specify:

We will need documentation showing that you have landlord approval for a dog

I Agree

We may need proof of ownership (e.g. council rates)

I Agree

Approximate size of fenced area where your dog will have access and be secure:

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What type of fencing do you have?

Your History

How many dogs have you owned before?

What breeds of dog have you owned?

Which Vet(s) have you used?

Have you had to surrender a dog before?

Yes
No

The Puppy / Dog In Your Home

Where will the animal live (e.g Inside/Outside - Sleeping Inside, Inside Only, Strictly Outside)

How will you keep your animal amused while at work or away from home?

How many hours will the dog/puppy be alone each day?

When on holidays, what will you do with your dog?

What would you do if your dog started jumping your fences?

What would you do if you had to move into a rental where no pets were allowed?

Have you ever had to provide serious Vet treatment for a pet?

Yes
No

Please provide details of treatment and cost involved:

What would you do if your pet needed a serious operation costing over $1000?

Is there anything else we should know in assessing your application?

Acc Name: Tiki Animal Rescue BSB: 650000 Acc Number: 518516204

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