Last Name (required)

First Name (required)

Address (required)

Suburb (required)

State (required) State (required) Victoria NSW Queensland South Australia Tasmania Western Australia Northern Territory

Postcode (required)

Best Contact Number (required)

Other Contact Number

Email Address (required)

Please confirm your email address (required)

Are you an Australian citizen or permanent resident of Australia (required) Are you an Australian citizen or permanent resident of Australia (required) Yes No

What type of residence do you live in? (required) What type of residence do you live in? (required) House Unit Apartment Townhouse Rural property

Is your home owned or rented? (required) Is your home owned or rented? (required) Own Rent

If owned, who is the home owner?

If renting, please email a copy of landlord approval to contact@arcticrescue.org.au

How old are you (the applicant) (required)

How many people live in your home?

Please list the ages of ALL other people living at the premises and their RELATIONSHIP to you, including children. (required)

Please indicate which dog(s) or breed(s) you are interested in adopting. (required)

Are there currently any other dogs living at your residence? (required) Are there currently any other dogs living at your residence? (required) Yes No

What are the AGE, BREED & GENDER of the dog or dogs living at your residence.

Are the other dogs living at your residence up to date with vaccinations? (required) Are the other dogs living at your residence up to date with vaccinations? (required) Yes No

Are the dogs currently living at your residence desexed? (required) Are the dogs currently living at your residence desexed? (required) Yes No

Have you owned an Arctic breed before? (required) Have you owned an Arctic breed before? (required) Yes No

What arctic breeds have you owned?

What other breeds of dogs have you owned in the past?

Do any cats live on your property, or do you intend to get a cat in the future? (required) Do any cats live on your property, or do you intend to get a cat in the future? (required) Yes I intend to get a cat in the future No

Are there any other animals on your property? (required) Are there any other animals on your property? (required) No Rabbits Poultry Birds Horses Livestock Other animals

Have you ever had to surrender or give away or re-home a pet you have previously owned? (required) Have you ever had to surrender or give away or re-home a pet you have previously owned? (required) Yes No

If yes, please briefly describe the circumstances of the surrender. (required)

What areas of your home will the dog have access to? Select all that apply. (required) What areas of your home will the dog have access to? Select all that apply. (required) All areas inside Some areas inside Backyard Other

Please describe other access areas

Do you currently have a doggie door? (required) Do you currently have a doggie door? (required) Yes No Not currently but willing to install if needed

Where will your dog sleep at night? (required)

What shelter will the dog have in your yard? (required)

What is the ground cover in your yard (tick all that are relevant) (required) What is the ground cover in your yard (tick all that are relevant) (required) Natural lawn/grass Synthetic grass Pavers Concrete Pebbles Decking Other

Is your yard fully and securely fenced? (required) Is your yard fully and securely fenced? (required) Yes No Partially

Please describe your fencing

How tall are your fences and gates? (the lowest point) (required)

What is the approximate size of the securely fenced yard where your dog will be kept? (required)

How often and for how long would you walk a dog? (required)

Will you walk the dog on or off the lead? Will you walk the dog on or off the lead? On-lead Off-lead Both

On average, how long will the dog be without human company each day?

Can you think of any reason you may need to give up this pet in the future? (required)

Tell us about you, your family and your interest in adopting a dog. (required)

If you have owned an arctic breed before, please tell us which breed and your experience with that dog. (required)

What do you know about the breed traits and requirements of the breed you are wanting to adopt? (required)

Tell us specifically what breed traits have attracted you to this breed. (required)

Are you prepared to attend training and events with your dog? (required)

Is there any other information you would like us to provide?

Which other rescue groups have you submitted an adoption application to?

How did you find out about Arctic Rescue Victoria? (required) How did you find out about Arctic Rescue Victoria? (required)Google searchPetrescueSavourLife Adopt-a-DogDogzonlineFacebookFriend/AcquaintanceBreed clubOther

PLEASE NOTE THAT THE FORM WILL NOT SUBMIT IF ANY REQUIRED FIELDS ARE NOT FILLED IN.