DUBLIN SPCA DOG ADOPTION APPLICATION FORM
Our chief concern at the Dublin SPCA Dogs & Cats Home is that dogs go to permanent homes where they will be happy, well cared for and healthy for the rest of
their lives. The dogs in our care are here because their owners couldn’t or more often wouldn’t care for them. Our primary duty is to the dog and we hope to match
each dog to a suitable owner. This is why we require all prospective owners to answer the following questions truthfully and give us as much information as possible
before selecting a dog.
Please complete the form in BLOCK CAPITALS.
***Please note you must be 21 years or older to adopt a Dublin SPCA orphaned pet***
Date: _________________Name of Dog you are interested in adopting:
Kennel No:
If we don't have a dog available that you are interested in adopting at the moment what type and age of dog are you interested in adopting?
Name of Applicant(s):
Date of Birth:
Address:
Home Tel:
Mobile :
Email:
Applicants Occupation:
Do you work? Full Time
Place of Work:
Number of Occupants at
the above address:
Adults
Type of Accomodation:
If Renting:
Name of Landlord:
House
Children
Ages of Children:
Apartment
Other
Part Time
(Please Circle)
(Please Circle)
Tel:
Is anyone in the household allergic to animals or have asthma?
or
Email:
Yes
No
(Please Circle)
Yes
No
(Please Circle)
If yes please state who and the specific allergy
Have you previously applied to the Dublin SPCA for a pet?
If yes, what type of animal and when
Are you willing to allow the Dublin SPCA to carry out a Home Check before and after you adopt your dog?
Yes
No
Please provide the name, address and phone number of your Veterinary Surgeon
What are your views on Neutering?
Agree
Disagree
(Please Circle)
Are you a monthly supporter of the Dublin SPCA?
Yes
No
(Please Circle)
Does your employer offer matching funds for employees charity donations?
Yes
No
Don’t Know (Please Circle)
I give my permission for the Dublin SPCA to contact me about their work
Yes
No
(Please Circle)
Office Use Only
Impound No:
Adoption Consultant:
FR DB No:
Payment Type:
Monthly Member (Y\N)
_______________________Donation:
______________________________________________________
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(Please Circle)
DUBLIN SPCA DOG ADOPTER SURVEY
Please tick or circle the answer most applicable to you. There are no right or wrong answers. We use this information to match you with right dog for you so please be honest.
I have owned a dog before:
No
Yes
Currently own
dog(s)
The last time I had a dog was:
2-10 years
ago
10+ years
ago
Not currently but within the
past year
My new dog needs to get along with
other dogs:
No
Yes
If yes please list names ages,
genders and breeds
My dog needs to be good with:
Children
under 10
years old
Children
over 10
years old
Elderly People
Cats
Other
Animals
My dog will primarily be an:
Inside Dog
Outside Dog
At night time my dog will:
Sleep in the
house
confined to
one room
Sleep
outdoors in
a kennel
Sleep outdoors
in a shed/
outhouse/
garage/stables
Sleep
indoors in a
crate
Sleep
indoors
with full
access to
house
How many hours will your dog spend
outside per day?
Please state:
My dog needs to be able to be alone
(per day)
2 hours or
less
4 hours or
less
4-8 hours
8-10 hours
12 hours +
When I am at home, I want my dog to
be by my side
All of the
time
Some of
time
Little of the
time
When I’m not at home, I want my dog to In the garage
spend their time
/ shed
In the back
garden
Loose in the
house
Confined to
one room
in the
house
In a crate
in the
house
I want a guard dog
No
Yes
I want my dog to hunt or herd with me
No
Yes
I want my dog to the the type that is
very enthusiastic in the way she shows
she loves people
Not at all
Somewhat
Very
I want my dog to be playful
Not at all
Somewhat
Very
I want my dog to be laid back
Not at all
Somewhat
Very
I am comfortable doing some training
with my dog to improve manners such
No training
as coming back to me, jumping, stealing
food, and pulling on the lead
Some
Training
A lot of training
I want to participate in Agility, Flyball or
No
Obedience Training with our dog
Yes
I would like to adopt a dog with “special
No
needs” (medical or behavioural)
Yes
It is most important to me that my dog...
Please make sure you have read the full application form then please sign and date.
I understand that adopting a dog is a commitment for the remainder of the dogs life and I will care for it according to the guidelines given by the Dublin SPCA. I
am aware that I must attend the next available dog training seminar at the shelter with King of Paws. If for any reason I am no longer able to care for and keep
the dog I will return it to the care of the Dublin SPCA. I understand that there maybe a waiting list and fees associated with returning a dog.
I declare that the information supplied in my application to adopt a dog is true. I confirm that I am over 21 years of age.
Signature:
Date:
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