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									VICTORIAN DOG RESCUE & RESOURCE GROUP INC. Dog Adoption Application
Please return this application to for speedy processing. If this is not possible return to Elsternwick PO Box 584, Elsternwick Vic 3185
These questions are aimed at making sure you realise the extra responsibilities that come with owning a dog, to help you determine what type of dog you are looking for, and to assist us in finding the right dog for you.

Name: Address: Suburb: Home Ph: Mobile: People living at premises: Adults Post Code: Work Ph: Email: : Children: Ages:

Are you enquiring about a particular dog? If a general enquiry please give size, breed and age of dog you would be interested in.

Why do you want to adopt a dog?

Do you currently have any pets? If so, what kind? Breed, age and sex?


Do your present pets (if any) have any behaviour or socialization problems? If so, please explain:

Has your current dog(if any) been C5 vaccinated in the last 12 months? (The C5 includes kennel cough component) Where do your existing pets (if any) sleep?

Where will your new dog sleep? Do you have a doggie door? Have you had any pets in the past? What happened to them?

Have you ever taken an animal to a shelter or released it to another party? If yes, please explain:

Does anyone in your house not want a new dog? If so, please explain: Please explain who will be the main caretaker of this pet: Have you been refused an adoption with any other breeder, rescue group or shelter? If so, please explain:

To your knowledge, is anyone in our family allergic to animals? If yes, please explain:


Is your yard securely fenced? If no-one is at home, where will the dog stay? Inside or Outside?

If the dog is outside does it have shelter? Will the dog have access to the front section of the house when you are not there?

How many hours will the dog be left alone for each day? Will the dog be allowed inside? How much of the time? Do you agree to return the dog to us should your circumstances change or the adoption not work out? If you have a swimming pool will the dog be separately fenced away from the pool? What will you do with your pet if you have to go out of town or move? Does your job require you to move or travel often? How often will you have time to walk the dog? Is there an off-leash area near you that you intend using? How do you plan on ensuring the dog’s safety outdoors?

What will you do if this pet has or develops behaviour problems?


Under what circumstance would you give up this pet? (E.g. Family illness, barking or digging, high cost vet bills).

Realising that dogs often live 15 years or older, are you willing to take responsibility for your pet’s entire life, keeping up to date with yearly vaccinations and tests?

What will you do if this pet becomes ill or injured and requires expensive veterinary care?

What will you do if your pet is lost?

Is there anything else you would like to tell us about you, your family or your interest in adopting a dog?

Have you checked with your council how many animals you are permitted to register?

If you are renting, please provide us with your landlords name and phone number for confirmation that a dog is permitted:

Do you currently have a vet? If so, please provide us their name and phone number so we can contact them for a reference:


If you do not have a vet, please provide the names and phone numbers of two personal references:

By submitting this application, I agree that all the information I have provided is correct. Providing untruthful answers or failure to comply with the requirements of this application or the signed adoption contract can result in the forfeiture of the adoption. You agree to allow us to check the references provided. We will require the successful applicant to sign an adoption agreement and allow a house/yard check before adoption. We may also ask to sight your driver’s licence before the application proceeds. We appreciate you taking the time to complete this application. Upon review and approval, we will contact you as soon as possible.

We reserve the right to refuse any applicant
Signed by Applicant (if completing online – application can be signed at a later date if the adoption proceeds)



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